Palanduz A, Telhan L, Yildirmak Y, Memioğlu N, Arapoğlu M, Kayaalp N
Department of Pediatrics, Sişli Etfal Hospital, Istanbul, Turkey.
J Paediatr Child Health. 2005 Jan-Feb;41(1-2):76-7. doi: 10.1111/j.1440-1754.2005.00543.x.
A 15-month-old boy was admitted with fever and a swollen knee. His mother had been treated for brucellosis 11 months ago. At that time he had been asymptomatic and had both negative blood culture and serum agglutination tests and breastfeeding had been stopped. The infant had been healthy since then. On admission, blood and joint fluid were obtained for culture and he was commenced on cefuroxim. Gram-negative coccobacillary organisms were seen in the joint fluid. Both cultures remained sterile. He had a positive serum agglutination test with a titer of 1/640. Cefuroxim was then stopped and the child was commenced on a specific course of treatment: gentamicin, trimethoprim-sulfamethoxazole and rifampicin. The infant recovered with this treatment. We conclude that this was brucellar arthritis of the knee and was probably acquired by breastmilk after an exceptionally long incubation period.
一名15个月大的男孩因发热和膝关节肿胀入院。他的母亲11个月前曾接受布鲁氏菌病治疗。当时他没有症状，血液培养和血清凝集试验均为阴性，且已停止母乳喂养。此后该婴儿一直健康。入院时，采集血液和关节液进行培养，并开始使用头孢呋辛治疗。在关节液中发现革兰氏阴性球杆菌。两次培养均无菌生长。他的血清凝集试验呈阳性，滴度为1/640。随后停用头孢呋辛，该患儿开始接受特定疗程的治疗：庆大霉素、甲氧苄啶-磺胺甲恶唑和利福平。该婴儿经此治疗后康复。我们得出结论，这是膝关节布鲁氏菌性关节炎，可能是在异常长的潜伏期后通过母乳感染的。
