Trauma Center Murnau, Prof.-Kuentscher-Strasse 8, Murnau, Germany.
Int J Infect Dis. 2010 Sep;14 Suppl 3:e233-5. doi: 10.1016/j.ijid.2009.08.009. Epub 2009 Dec 9.
Septic arthritis caused by Streptococcus zooepidemicus is a rare event in humans. Of the four cases reported in the literature, only two patients had direct animal contact, and the portal of entry remained unclear in all cases. We report herein the case of a patient who suffered a purulent arthritis of the left shoulder caused by S. zooepidemicus, successfully treated in our department. A diagnostic FDG-PET-CT scan ruled out other foci of infection, but detected a hyperkeratotic plantar chronic soft tissue lesion of the left foot, acquired in a paragliding accident 10 years earlier. The fact that the patient habitually took care of his horses barefoot in boots, identifies the cutaneous portal of entry as most likely. To our knowledge this is the first report of a septic arthritis caused by S. zooepidemicus where a cutaneous entry route is described.
兽疫链球菌引起的脓毒性关节炎在人类中较为罕见。文献中报道的 4 例病例中，仅有 2 例患者有直接的动物接触，所有病例的感染门户均不明确。我们在此报告 1 例在我科成功治疗的由兽疫链球菌引起的左侧肩部脓性关节炎患者。FDG-PET-CT 扫描排除了其他感染灶，但发现了 10 年前在滑翔事故中获得的左足跖部角化过度的慢性软组织病变。患者习惯赤脚穿靴子照顾他的马，这表明皮肤是最有可能的感染门户。据我们所知，这是首例描述皮肤感染途径的由兽疫链球菌引起的脓毒性关节炎病例。
