Mahmoud Samer S S, Odak Saurabh, Qazzafi Zaman, McNicholas M J
Department of Trauma and Orthopaedics, University Hospital Aintree, Liverpool, UK.
BMJ Case Rep. 2012 Sep 17;2012:bcr2012006179. doi: 10.1136/bcr-2012-006179.
We report an unusual case of a Serratia marcescens infection of total knee arthroplasty 4 weeks after the procedure following aspiration carried out on the ward (contrary to local protocol). This was successfully treated with thorough wound debridement, irrigation, change of the polyethylene liner and systemic antibiotics using intravenous meropenem for 3 weeks followed by oral ciprofloxacin for another 3 weeks. Our patient made an uneventful recovery and there was no reported recurrence of infection at 8 months of follow-up. We are unsure as to whether the infection was introduced at the time of the joint aspiration or was a complication of the initial procedure despite all the standard aseptic measures taken at the time of surgery.
我们报告了一例不寻常的病例，患者在病房进行抽吸（与当地规程相悖）4周后，全膝关节置换术后发生粘质沙雷氏菌感染。通过彻底的伤口清创、冲洗、更换聚乙烯衬垫以及使用静脉注射美罗培南进行3周的全身抗生素治疗，随后再口服环丙沙星3周，成功治愈了该感染。我们的患者恢复顺利，在8个月的随访中未报告感染复发。尽管手术时采取了所有标准的无菌措施，但我们不确定感染是在关节抽吸时引入的，还是初始手术的并发症。
