妊娠相关性化脓性骶髂关节炎：病例报告及文献复习
Pregnancy-associated pyogenic sacroiliitis: case report and review.
作者信息
Almoujahed Mohammad O, Khatib Riad, Baran Joseph
机构信息
Division of Infectious Diseases, Department of Internal Medicine, St John Hospital and Medical Center, Detroit, MI, USA.
出版信息
Infect Dis Obstet Gynecol. 2003;11(1):53-7. doi: 10.1155/S1064744903000073.
BACKGROUND
Pyogenic sacroiliitis occurs infrequently during the peripartum period.
CASE
A case at our institution and a review of the literature were analyzed. A total of 15 cases were discovered. The onset of illness was during pregnancy (40% of cases), within 3 weeks postpartum (40%) or post-abortion (20%), and the presentation was usually acute (< 7 days in 67% of cases). Frequent manifestations included localized pain in the hips or buttock, sacroiliac joint tenderness and fever. Computed tomography or magnetic resonance imaging revealed joint involvement in all cases tested. Microbiology was confirmed by blood (40%) or joint aspirate (75%), and most patients were treated with antibiotics. Surgical intervention took place in five cases. Preterm labor was reported in only one case. All patients responded well to therapy without locomotive disability, and persistent pain was uncommon.
CONCLUSION
Septic sacroiliitis should be considered in peripartum patients who present with fever and severe localized pain. Medical management is usually curative, and without an adverse effect on pregnancy.
背景
化脓性骶髂关节炎在围产期很少发生。
病例
分析了我们机构的一例病例并回顾了文献。共发现15例病例。发病时间为孕期（40%的病例）、产后3周内（40%）或流产后（20%），通常表现为急性起病（67%的病例病程<7天）。常见表现包括臀部或髋部局部疼痛、骶髂关节压痛和发热。计算机断层扫描或磁共振成像显示所有接受检查的病例均有关节受累。通过血液（40%）或关节穿刺液（75%）确诊微生物感染，大多数患者接受了抗生素治疗。5例患者接受了手术干预。仅1例报告有早产。所有患者对治疗反应良好，无运动功能障碍，持续性疼痛并不常见。
结论
对于出现发热和严重局部疼痛的围产期患者，应考虑感染性骶髂关节炎。药物治疗通常可治愈，且对妊娠无不良影响。
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