Vranis Neil, Paryavi Ebrahim, Christian Matthew, Joshi Manjari, Pensy Raymond A
R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD.
Am J Orthop (Belle Mead NJ). 2015 Jul;44(7):E239-41.
This report presents a case of progressive septic arthritis and osteomyelitis caused by a rare pathogen, Pasteurella multocida, thought to be provoked by the use of systemic corticosteroids. Despite initial improvement after antibiotics and surgical procedure, the patient returned with new, associated symptoms 1 month later. This concurrent set of circumstances leading to a life-threatening condition has not been reported, to the best of our knowledge. Physicians aware of such a case will be better prepared to diagnose, treat, and educate their patients. Additionally, the diagnostic challenge presented by this case report emphasizes the need for vigilance and thoroughness in obtaining histories from patients presenting with seemingly benign complaints, especially in vulnerable populations, such as infants, pregnant women, and immunocompromised adults.
本报告介绍了一例由罕见病原体多杀巴斯德菌引起的进行性化脓性关节炎和骨髓炎病例,据认为是全身使用糖皮质激素诱发的。尽管抗生素治疗和手术后病情初步好转,但患者1个月后出现新的相关症状再次就诊。据我们所知,这种并发情况导致危及生命的状况尚未见报道。了解此类病例的医生将更有准备地对患者进行诊断、治疗和教育。此外,本病例报告所呈现的诊断挑战强调,对于看似良性主诉的患者,尤其是婴儿、孕妇和免疫功能低下的成年人等弱势群体,在获取病史时需要保持警惕并全面细致。