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非结核分枝杆菌引起的跟骨骨髓炎:一例报告

Calcaneal Osteomyelitis due to Non-tuberculous Mycobacteria: A Case Report.

作者信息

Yi Tae-Im, Ha Seung-A, Choe Yeo-Reum, Kim Joo-Sup, Kwon Kye-Won

机构信息

Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea.

Department of Pathology, Bundang Jesaeng General Hospital, Seongnam, Korea.

出版信息

Ann Rehabil Med. 2016 Feb;40(1):172-6. doi: 10.5535/arm.2016.40.1.172. Epub 2016 Feb 26.

Abstract

Osteomyelitis is a bone infection caused by bacteria or other germs. Gram-positive cocci are the most common etiological organisms of calcaneal osteomyelitis; whereas, non-tuberculous mycobacteria (NTM) are rarely documented. We reported a case of NTM calcaneal osteomyelitis in a 51-year-old female patient. She had been previously treated in many local clinics with multiple local steroid injection over 50 times and extracorporeal shock-wave therapy over 20 times with the impression of plantar fasciitis for 3 years prior. Diagnostic workup revealed a calcaneal osteomyelitis and polymerase chain reaction assay on bone aspirate specimens confirmed the diagnosis of non-tuberculous mycobacterial osteomyelitis. The patient had a partial calcanectomy with antitubercular therapy. Six months after surgery, a follow-up magnetic resonance imaging showed localized chronic osteomyelitis with abscess formation. We continued anti-tubercular therapy without operation. At 18-month follow-up after surgery and comprehensive rehabilitation therapy, she was ambulating normally and able to carry out her daily activities without any discomfort.

摘要

骨髓炎是一种由细菌或其他病菌引起的骨感染。革兰氏阳性球菌是跟骨骨髓炎最常见的病原体;然而,非结核分枝杆菌(NTM)引起的病例鲜有报道。我们报告了一例51岁女性患者的NTM跟骨骨髓炎。她此前在多家当地诊所接受治疗,3年来因足底筋膜炎接受了50多次局部类固醇注射和20多次体外冲击波治疗。诊断检查发现跟骨骨髓炎,骨穿刺标本的聚合酶链反应检测确诊为非结核分枝杆菌骨髓炎。该患者接受了部分跟骨切除术并进行抗结核治疗。术后6个月,随访磁共振成像显示局部慢性骨髓炎伴脓肿形成。我们继续进行抗结核治疗,未进行手术。术后18个月随访及综合康复治疗后,她行走正常,能够毫无不适地进行日常活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b90e/4775752/903af56d738c/arm-40-172-g001.jpg

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