Straticiuc Sergiu, Ignat Ancuta, Hanganu Elena, Lupu Vasile Valeriu, Ciubara Alexandru Bogdan, Cretu Roxana
From the Pediatric Orthopaedic Department, "St. Mary" Emergency Children Hospital (SS, RC); Pediatrics Department (AI, VVL); Pediatric Surgery Department (EH); and Anatomy Department, University of Medicine and Pharmacy "Gr. T. Popa"; Orthopaedics Clinic, "St. Spiridon" Emergency Clinical Hospital, Iasi, Romania (ABC).
Medicine (Baltimore). 2016 Feb;95(5):e2745. doi: 10.1097/MD.0000000000002745.
Neisseria meningitidis (N. meningitidis) is associated with severe invasive infections such as meningitis and fulminant septicemia. Septic arthritis due to N. meningitidis is rare and bone infections have been reported exceptionally. We report the case of a 1-year old girl who presented with a painful, swollen right knee, accompanied by fever and agitation. Arthrocentesis of the right knee, while patient was under anesthesia, yielded grossly purulent fluid, so we made arthrotomy and drainage. The culture from synovial fluid revealed N. meningitidis, sensitive to Ceftriaxone. The patient received intravenous antibiotherapy with Ceftriaxone. The status of the patient improved after surgical drainage and intravenous antibiotic therapy. She recovered completely after 1 month.
This observation illustrates an unusual presentation of invasive meningococcal infection and the early identification of the bacteria, combined with the correct treatment, prevent the complications and even death.
脑膜炎奈瑟菌(N. meningitidis)与严重的侵袭性感染有关,如脑膜炎和暴发性败血症。由脑膜炎奈瑟菌引起的化脓性关节炎罕见,骨感染的报道更是罕见。我们报告一例1岁女童,她出现右膝关节疼痛、肿胀,伴有发热和烦躁不安。在患者麻醉状态下对右膝关节进行关节穿刺,抽出大量脓性液体,因此我们进行了关节切开引流。滑膜液培养显示为脑膜炎奈瑟菌,对头孢曲松敏感。患者接受了头孢曲松静脉抗生素治疗。手术引流和静脉抗生素治疗后患者状况改善。1个月后她完全康复。
本病例说明了侵袭性脑膜炎球菌感染的一种不寻常表现,细菌的早期识别以及正确的治疗可预防并发症甚至死亡。