Stecher D R, Gusis S E, Maldonado Cocco J A
Sección Reumatología, Instituto Nacional de Rehabilitación Psicofísica, Buenos Aires, Argentina.
Medicina (B Aires). 1991;51(3):238-40.
In order to describe the features of septic arthritis (SA) in patients with connective tissue diseases (CTDs), a series of 17 CTD cases with SA episodes were studied retrospectively. The most common CTDs were systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Involvement was oligoarticular in 64% of cases and mono-articular in the remainder. Clinical, radiological and laboratory findings proved insufficient to allow differential diagnosis between SA and an underlying arthritic flare-up, which could only be carried out by bacterial isolation from synovial fluid. The most frequent etiological agent was Staphylococcus aureus (Table 1). Throughout, patients were treated by needle drainage together with antibiotics, first by parenteral (average 17 days) and later by oral route (average 46 days). Cases with greater diagnostic delay and initiation of therapy were those requiring arthrotomy and those who presented more complications mainly osteomyelitis and permanent disability (Table 2).
为描述结缔组织病（CTD）患者感染性关节炎（SA）的特征，回顾性研究了17例发生SA发作的CTD病例。最常见的CTD是系统性红斑狼疮（SLE）和类风湿关节炎（RA）。64%的病例为少关节受累，其余为单关节受累。临床、放射学和实验室检查结果不足以区分SA与潜在的关节炎发作，只能通过从滑液中分离细菌来进行鉴别诊断。最常见的病原体是金黄色葡萄球菌（表1）。患者全程接受针吸引流并联合使用抗生素治疗，首先采用胃肠外给药（平均17天），随后改为口服给药（平均46天）。诊断延迟时间更长且开始治疗较晚的病例是那些需要关节切开术的患者以及出现更多并发症（主要是骨髓炎和永久性残疾）的患者（表2）。
