Kalouche Ibrahim, Ghanem Ismat, Kharrat Khalil, Dagher Fernand
Department of Orthopaedic Surgery, Hôtel-Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon.
J Pediatr Orthop B. 2005 Jan;14(1):55-60. doi: 10.1097/01202412-200501000-00010.
Rib osteomyelitis is a rare disease. We present a previously unreported case of Streptococcus pneumoniae osteomyelitis of the rib. A 4-month-old-infant presented with fever, irritability and abdominal tenderness. Pericostal collection was discovered incidentally on ultrasound; it was first drained by needle aspiration and appropriate antibiotic therapy was given, with resolution of fever in 24 h, but recurrence of symptoms 4 days later, with swelling over the affected rib. Surgical drainage with resection of the infected portion of the rib were done followed by a prolonged course of intravenous and then oral antibiotics, without any recurrence at 6 months follow-up. A review of the pertinent literature was made. This case demonstrates that the spectrum of pathogens potentially responsible for rib osteomyelitis may be broader than previously reported. The management and outcome are similar to rib osteomyelitis due to any other bacteria.
肋骨骨髓炎是一种罕见疾病。我们报告一例此前未报道过的由肺炎链球菌引起的肋骨骨髓炎病例。一名4个月大的婴儿出现发热、易激惹和腹部压痛。超声检查偶然发现肋周积液；首先通过针吸进行引流，并给予适当的抗生素治疗，24小时内发热消退，但4天后症状复发，患侧肋骨肿胀。随后进行了手术引流并切除肋骨感染部分，接着长期静脉注射抗生素，之后改为口服抗生素，6个月随访时无任何复发。我们还对相关文献进行了综述。该病例表明，可能导致肋骨骨髓炎的病原体范围可能比之前报道的更广。其治疗方法和结果与由任何其他细菌引起的肋骨骨髓炎相似。
