关节周围浸润后由尖端赛多孢菌引起的缓慢起病的化脓性关节炎
[Slow onset septic arthritis by Scedosporium apiospermum after periarticular infiltration].
作者信息
Ramos Martínez Antonio, Orden Martínez Beatriz, Polo Laborda Jessica, García Magallón Blanca, Fernández Castro Mónica, Ortega Sánchez Carlos, Gil Navarro Manuel
机构信息
Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Majadahonda, Madrid, España.
出版信息
Rev Iberoam Micol. 2012 Oct-Dec;29(4):241-4. doi: 10.1016/j.riam.2012.02.001. Epub 2012 Feb 21.
BACKGROUND
Fungal arthritis is usually of haematogenous origin, and mainly affects patients with impaired cellular immunity or users of intravenous drugs. The infection in immunocompetent patients is generally caused by direct inoculation of the microorganism through an invasive device. The experience of azole therapy in these patients is limited.
CASE REPORT
We report a case of arthritis caused by Scedosporium apiospermum characterized by its slow onset, lack of response to posaconazole and caspofungin, and its successful resolution after surgical debridement and treatment with voriconazole.
CONCLUSIONS
Treatment with voriconazole and surgical debridement is an effective therapy for arthritis due to S. apiospermum.
背景
真菌性关节炎通常血行播散而来，主要影响细胞免疫受损患者或静脉药物使用者。免疫功能正常患者的感染一般由微生物通过侵入性装置直接接种所致。这些患者使用唑类疗法的经验有限。
病例报告
我们报告1例由尖端赛多孢菌引起的关节炎病例，其特点为起病缓慢，对泊沙康唑和卡泊芬净无反应，经手术清创及伏立康唑治疗后成功缓解。
结论
伏立康唑治疗联合手术清创是治疗尖端赛多孢菌所致关节炎的有效方法。
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