Martínez Pastor Juan Carlos, Casanova Mora Luis, Vilchez Cavazos Félix, Lozano Lizárraga Luis, Castillo García Félix, Soriano Viladomiu Alex
Hospital Clinic, Barcelona, Españia.
Acta Ortop Mex. 2009 Sep-Oct;23(5):302-5.
Acute blood borne prosthetic infections occur in patients with an asymptomatic prosthesis that, after an infection involving bacteremia, produces bacterial implantation in the prosthesis and causes an acute infection. This type of infection is usually caused by gram positive cocci, Streptococci and Staphylococci. We present the clinical case of a patient without a history of immunodeficiency, who had an acute blood borne knee prosthetic infection caused by Listeria monocytogenes.
The diagnosis of infection was made based on the clinical data, blood tests and the positive culture of an arthrocentesis. A prosthetic exchange was performed in two stages.
After the revision arthroplasty, the patient was still infection free at the 24-month followup.
This type of infection is rare, with very few cases published in the literature, and without a defined treatment modality. The two-stage prosthetic exchange is a valid alternative in prosthetic infections caused by this microorganism and avoids suppressive antibiotic therapy.
急性血源性人工关节感染发生于假体无症状的患者,在发生涉及菌血症的感染后,细菌植入假体并引发急性感染。这类感染通常由革兰氏阳性球菌、链球菌和葡萄球菌引起。我们报告一例无免疫缺陷病史的患者,其急性血源性膝关节假体感染由产单核细胞李斯特菌引起。
根据临床资料、血液检查及关节穿刺培养阳性结果做出感染诊断。分两期进行假体置换。
翻修关节置换术后,患者在24个月的随访中仍未发生感染。
这类感染较为罕见,文献报道的病例极少,且尚无明确的治疗方式。两期假体置换是由这种微生物引起的假体感染的一种有效替代方法,可避免使用抑制性抗生素治疗。