Garner Amy J, Sundram Freda, Harris Kathryn
Barnet General Hospital, Wellhouse Lane, Herts, Barnet EN5 3DJ, UK.
Case Rep Orthop. 2011;2011:862487. doi: 10.1155/2011/862487. Epub 2011 Oct 19.
Septic arthritis is an Orthopaedic emergency, threatening the joint within hours of onset. Up to 10% of cases of meningococcaemia have an associated septic arthritis. The aetiology of acute meningococcaemia in a variety of clinical syndromes is well documented in the literature. The pathogen Neisseria meningitidis can cause both primary and secondary manifestations of disseminated infection. Broad-range 16S rDNA PCR is a relatively new technique, useful in identifying aetiological agents in septic patients with negative blood cultures. Here, we describe the rare clinical scenario of a 76-year-old woman with primary meningococcal septic arthritis of a native shoulder joint without associated meningococcal bloodstream infection. We discuss the role of 16s rDNA Polymerase Chain Reaction (PCR) in the identification of the infectious agent, Neisseria meningitidis, and the role of this technique in guiding subsequent management.
化脓性关节炎是一种骨科急症,发病数小时内就会危及关节。高达10%的脑膜炎球菌血症病例伴有化脓性关节炎。文献中对各种临床综合征中急性脑膜炎球菌血症的病因已有充分记载。病原菌脑膜炎奈瑟菌可引起播散性感染的原发性和继发性表现。广谱16S rDNA聚合酶链反应(PCR)是一种相对较新的技术,有助于在血培养阴性的脓毒症患者中鉴定病原体。在此,我们描述了一名76岁女性罕见的临床病例,该患者患有原发性肩关节脑膜炎球菌性化脓性关节炎,且无相关的脑膜炎球菌血流感染。我们讨论了16S rDNA聚合酶链反应(PCR)在鉴定病原体脑膜炎奈瑟菌中的作用,以及该技术在指导后续治疗中的作用。