Wang Chin-Fu, Lee Guan-Hsien, Wang Chih-Lu
Department of Pediatrics, E-Da Hospital/I-Shou University, Kaohsiumg County.
Acta Paediatr Taiwan. 2005 Mar-Apr;46(2):87-90.
Childhood septic arthritis is not only an uncommon presentation with polyarticular involvement, but is also rarely complicated with thromboembolism. We report a case of a 10-year-old boy who suffered multiple staphylococcal arthritis, deep vein thrombosis, pulmonary embolism, pericardial effusion and occlusion of the anterior parietal branch of the right middle cerebral artery. Oxacillin-sensitive Staphylococcus aureus was isolated from blood, synovial fluid and pericardial effusion. Intravenous six-week oxacillin combined with two-week gentamicin for eradicating the pathogen, arthrotomy for debridment and subcutaneous low-molecular-weight heparin for preventing further thromboembolism were administered during admission. In addition, surveys for immunodeficiency, connective tissue disease and hemostatic dysfunction produced negative findings. The patient was discharged with neither painful disability of involved joints nor neurological sequelae.
儿童化脓性关节炎不仅是一种罕见的多关节受累表现，而且很少并发血栓栓塞。我们报告一例10岁男孩，他患有多发性葡萄球菌关节炎、深静脉血栓形成、肺栓塞、心包积液以及右大脑中动脉前顶支闭塞。从血液、滑液和心包积液中分离出对苯唑西林敏感的金黄色葡萄球菌。住院期间给予六周静脉注射苯唑西林联合两周庆大霉素以根除病原体，进行关节切开术清创，并皮下注射低分子肝素以预防进一步的血栓栓塞。此外，免疫缺陷、结缔组织病和止血功能障碍的检查结果均为阴性。患者出院时受累关节无疼痛性残疾，也无神经后遗症。
