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肱骨干急性骨髓炎酷似恶性肿瘤:免疫功能正常的成人中以肺炎链球菌为罕见病原体

Acute osteomyelitis of the humerus mimicking malignancy: Streptococcus pneumoniae as exceptional pathogen in an immunocompetent adult.

机构信息

Clinic for Orthopaedics and Sports Orthopaedics, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Straße 22, D-81675, Munich, Germany.

出版信息

BMC Infect Dis. 2013 Jun 5;13:266. doi: 10.1186/1471-2334-13-266.

Abstract

BACKGROUND

Chronic osteomyelitis due to direct bone trauma or vascular insufficiency is a frequent problem in orthopaedic surgery. In contrast, acute haematogenous osteomyelitis represents a rare entity that almost exclusively affects prepubescent children or immunodeficient adults.

CASE PRESENTATION

In this article, we report the case of acute pneumococcal osteomyelitis of the humerus in an immunocompetent and otherwise healthy 44-year-old male patient presenting with minor inflammation signs and misleading clinical features.

CONCLUSIONS

The diagnosis had to be confirmed by open biopsy which allowed the initiation of a targeted therapy. A case of pneumococcal osteomyelitis of a long bone, lacking predisposing factors or trauma, is unique in adults and has not been reported previously.

摘要

背景

由直接骨创伤或血管功能不全引起的慢性骨髓炎是矫形外科的常见问题。相比之下,急性血源性骨髓炎是一种罕见的疾病,几乎只影响青春期前的儿童或免疫功能低下的成年人。

病例介绍

本文报告了一例免疫功能正常且健康的 44 岁男性患者的急性肺炎链球菌性肱骨干骨髓炎,该患者表现为轻微炎症体征和具有误导性的临床特征。

结论

通过开放性活组织检查确认了诊断,从而开始了靶向治疗。成人中没有先前报道过的、缺乏诱发因素或创伤的长骨肺炎链球菌性骨髓炎病例是独特的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fc1/3679722/bc8c67c598cf/1471-2334-13-266-1.jpg

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