Allianatos Panagiotis G V, Tilentzoglou Anastasia C, Koutsoukou Alexander D
Sports Injuries Department, KAT Hospital, Athens, Greece.
Arthroscopy. 2003 Mar;19(3):E26. doi: 10.1053/jars.2003.50077.
A case of septic arthritis caused by Erysipelothrix rhusiopathiae, after an arthroscopically assisted anterior cruciate ligament (ACL) substitution in a non-immunosuppressed patient is described. An 18-year-old man underwent an ACL reconstruction with a quadruple hamstring graft. Eight days postoperatively, the patient developed fever, knee pain, and effusion without erythema or suppuration. He was readmitted to the hospital with the diagnosis of septic arthritis. The patient's erythrocyte sedimentation rate, C-reactive protein level, and white blood cell count were high. The joint was aspirated and the fluid was sent for cultures that revealed the presence of E rhusiopathiae. E rhusiopathiae is widespread in nature, it is transmitted by direct cutaneous laceration, and it causes septic arthritis, meningitis, endocarditis, and renal failure in immunosuppressed people with poor prognosis. In our case, the infection was treated with arthroscopic lavage and debridement, retention of the graft and hardware, and intravenous antibiotic administration for 6 weeks, followed by oral administration for 16 weeks.
本文描述了一例在非免疫抑制患者进行关节镜辅助下前交叉韧带(ACL)置换术后,由猪红斑丹毒丝菌引起的化脓性关节炎病例。一名18岁男性接受了四股绳肌移植的ACL重建手术。术后8天,患者出现发热、膝关节疼痛和积液,但无红斑或化脓。他因化脓性关节炎的诊断再次入院。患者的红细胞沉降率、C反应蛋白水平和白细胞计数均升高。对关节进行了穿刺抽吸,并将液体送去培养,结果显示存在猪红斑丹毒丝菌。猪红斑丹毒丝菌在自然界广泛存在,通过皮肤直接裂伤传播,在免疫抑制且预后不良的人群中可引起化脓性关节炎、脑膜炎、心内膜炎和肾衰竭。在我们的病例中,感染通过关节镜冲洗和清创、保留移植物和硬件,并静脉注射抗生素6周,随后口服抗生素16周进行治疗。