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系统性红斑狼疮患者的脓性肌炎及文献综述

Pyomyositis in a patient with systemic lupus erythaematosus and a review of the literature.

作者信息

Meesiri Somchai

机构信息

Department of Surgery, Mae Sot General Hospital, Mae Sot, Tak, Thailand.

出版信息

BMJ Case Rep. 2016 Apr 18;2016:10.1136/bcr-2016-214809. doi: 10.1136/bcr-2016-214809.

Abstract

Pyomyositis (PM) is a common masquerading disease that is frequently misdiagnosed. A concurrent state of immunodeficiency is observed in up to 75% of tropical PM cases. PM in systemic lupus erythaematosus (SLE) is a relatively rare disease. I report a case of PM that was caused byKlebsiella pneumoniaein a patient with SLE who presented with leg pain, fever and a lupus flare-up. The patient was correctly diagnosed using a CT scan. Immediate surgical drainage was performed, and empirical antibiotics were administered. The patient was discharged while in a recovering condition. The clinical features, the results of radiographic investigations and the management of PM in SLE are synopsised in this article to underscore the importance of considering this relatively rare disease during differential diagnosis in patients with SLE with muscle pain with or without fever. I also emphasise the need to exclude mycobacterial infection in patients with SLE with PM.

摘要

脓性肌炎(PM)是一种常见的易误诊疾病。在高达75%的热带地区PM病例中观察到存在免疫缺陷并发状态。系统性红斑狼疮(SLE)患者并发PM是一种相对罕见的疾病。我报告一例由肺炎克雷伯菌引起的PM病例,该患者为SLE患者,表现为腿痛、发热和狼疮病情加重。通过CT扫描对患者进行了正确诊断。立即进行了手术引流,并给予经验性抗生素治疗。患者在恢复状态下出院。本文总结了SLE患者并发PM的临床特征、影像学检查结果及治疗方法,以强调在对有或无发热的肌肉疼痛的SLE患者进行鉴别诊断时考虑这种相对罕见疾病的重要性。我还强调在SLE并发PM的患者中需要排除分枝杆菌感染。

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本文引用的文献

1
Pyomyositis in childhood-systemic lupus erythematosus.儿童脓性肌炎与系统性红斑狼疮
Rev Bras Reumatol Engl Ed. 2016 Jan-Feb;56(1):79-81. doi: 10.1016/j.rbre.2014.04.005. Epub 2014 Nov 27.
5
Management of infection in systemic lupus erythematosus.系统性红斑狼疮感染的管理。
Best Pract Res Clin Rheumatol. 2013 Jun;27(3):377-89. doi: 10.1016/j.berh.2013.07.002.
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