全髋关节置换术后晚期沙门氏菌感染的成功治疗——两例报告。
Successful treatment of late Salmonella infections in total hip replacement - report of two cases.
机构信息
Department of Orthopaedics, University of Szeged, 6 Semmelweis Street, Szeged 6720, Hungary.
出版信息
BMC Infect Dis. 2010 Jun 8;10:160. doi: 10.1186/1471-2334-10-160.
BACKGROUND
Salmonella species can be rarely isolated from periprosthetic joint infections, however when present, are usually part of a severe septic clinical picture.
CASE PRESENTATIONS
Two patients presented with late infected hip replacements to our institution. The first patient with multiple comorbidities had a confirmed Salmonella Enteridis infection with an abscess in the groin, with loosening of both components. He underwent a successful one stage cemented revision hip replacement, followed by 6 weeks of antibiotic therapy (ciprofloxacin). He had no recurrence or complications. The second patient was admitted in a septic condition with ARDS to the Intensive Care Unit 7 years following an uncemented total hip replacement. From an ultrasound guided hip aspirate Salmonella cholerae-suis was isolated. He underwent a successful a two-stage revision hip replacement.
CONCLUSIONS
Successful treatment of such potentially life threatening infections is achievable using modern orthopaedic techniques and close collaboration with the infectious diseases specialists.
背景
虽然来自假体周围关节感染的沙门氏菌属菌株非常少见，但当它们出现时，通常是严重脓毒症临床症状的一部分。
病例介绍
两名患者因晚期感染的髋关节置换术而转入我院。第一位合并多种合并症的患者经证实为肠炎沙门氏菌感染，腹股沟脓肿形成，两个部件均松动。他成功地进行了一期水泥固定翻修髋关节置换术，随后接受了 6 周的抗生素治疗（环丙沙星）。他没有复发或并发症。第二位患者在无骨水泥全髋关节置换术后 7 年因急性呼吸窘迫综合征（ARDS）入住重症监护病房，处于脓毒症状态。从超声引导的髋关节抽吸物中分离出霍乱弧菌。他成功地进行了两期翻修髋关节置换术。
结论
采用现代骨科技术并与传染病专家密切合作，可成功治疗此类危及生命的感染。
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