Wasserman Adrienne R, Melville Laura D, Birkhahn Robert H
Department of Emergency Medicine, New York Methodist Hospital, Brooklyn, New York 11215, USA.
J Emerg Med. 2009 Oct;37(3):269-72. doi: 10.1016/j.jemermed.2007.03.005. Epub 2007 Jul 20.
We describe the case of a 44-year-old man who presented to the Emergency Department (ED) complaining of pain and swelling over the left elbow of 1-week duration. After olecranon bursal aspiration, synovial fluid analysis yielded an increased white blood cell count (3040 cells/mm(3)) and the presence of bacteria. Culture of the fluid later grew Staphylococcus aureus. The patient was initially treated with oral antibiotics for septic bursitis and returned to the orthopedics clinic for follow-up 2 days later with interval worsening of symptoms. He was subsequently admitted for parenteral antibiotics and surgical wash-out of the affected bursa. This report briefly discusses the clinical history and appropriate diagnostic evaluation for septic olecranon bursitis, as well as the shortcomings of existing treatment guidelines.
我们描述了一名44岁男性的病例,他因左肘部疼痛和肿胀持续1周就诊于急诊科。鹰嘴滑囊穿刺后,滑液分析显示白细胞计数升高(3040个细胞/mm³)且存在细菌。该液体培养后来培养出金黄色葡萄球菌。患者最初接受口服抗生素治疗脓毒性滑囊炎,2天后返回骨科诊所进行随访,症状在此期间加重。随后他因接受肠外抗生素治疗和对受影响的滑囊进行手术冲洗而入院。本报告简要讨论了脓毒性鹰嘴滑囊炎的临床病史和适当的诊断评估,以及现有治疗指南的不足之处。