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[由单核细胞增生李斯特菌引起的人工髋关节感染]

[Prosthetic hip joint infection caused by Listeria monocytogenes].

作者信息

Tabib W, Guiffault P, Lemort C Brocard, Berrada H

机构信息

Service de Chirurgie Orthopédique, Groupe hospitalier du Havre, 29-avenue, P. Mendes France, 76290 Montivilliers, France.

出版信息

Acta Orthop Belg. 2002 Apr;68(2):182-6.

Abstract

The authors report an unusual case of prosthetic hip joint infection caused by Listeria monocytogenes. The patient, an 87-year-old lady who had undergone a right total hip replacement 10 years previously, presented with pain and restriction of hip motion three weeks after an episode of abdominal pain. Aspiration of the joint yielded a dark fluid, from which Listeria Monocytogenes type 4-b was isolated. Blood cultures remained negative. After prolonged antibiotic therapy, symptoms gradually resolved. A few months later, pain recurred with radiological signs of loosening of the femoral component. One-stage revision arthroplasty was performed combined with antibiotic treatment. The patient remains asymptomatic at one year follow-up. Laboratory data and x-ray control are normal. Prosthetic hip joint infection with Listeria monocytogenes is uncommon; few cases have been reported. The literature review shows that prolonged antibiotic therapy alone may be used in patients for whom removal of the prosthesis is not desirable, although revision arthroplasty or prosthesis removal remains necessary in the other cases.

摘要

作者报告了一例由单核细胞增生李斯特菌引起的人工髋关节感染的罕见病例。患者为一名87岁女性,10年前接受了右侧全髋关节置换术,在一次腹痛发作三周后出现髋关节疼痛和活动受限。关节穿刺抽出深色液体,从中分离出4-b型单核细胞增生李斯特菌。血培养结果仍为阴性。经过长时间的抗生素治疗,症状逐渐缓解。几个月后,疼痛复发,伴有股骨部件松动的放射学迹象。进行了一期翻修关节成形术并联合抗生素治疗。在一年的随访中,患者无症状。实验室数据和X线检查正常。单核细胞增生李斯特菌引起的人工髋关节感染并不常见,仅有少数病例报道。文献综述表明,对于不希望取出假体的患者,可单独使用延长疗程的抗生素治疗,尽管在其他情况下仍需要进行翻修关节成形术或取出假体。

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