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小儿肩部化脓性关节炎:从婴儿期到青春期

Septic Arthritis of the Pediatric Shoulder: From Infancy to Adolescence.

作者信息

Walker Justin W, Hennrikus William L

机构信息

College of Medicine, The Pennsylvania State University, Hershey, PA 17033, USA.

College of Medicine, The Pennsylvania State University, Hershey, PA 17033, USA; Penn State Hershey Medical Center, Bone and Joint Institution, Hershey, PA 17033, USA.

出版信息

Int J Pediatr. 2016;2016:3086019. doi: 10.1155/2016/3086019. Epub 2016 Aug 21.

Abstract

Background. Septic arthritis of the glenohumeral joint in the pediatric population (<18 yo) is not commonly described in the literature. There is a corresponding paucity of information regarding its presentation and treatment. Methods. An IRB approved review of patients treated with irrigation and debridement by the Orthopaedic Department was completed. This retrospective study includes four patients, presenting from 2005 to 2015, with septic arthritis of the shoulder. Results. The mean age (M age) at presentation was 5 years, with a range of 1 month to 15 years. Patients presented on average after 7 days with pain and a mean temperature of 39°C, erythrocyte sedimentation rate of 66 mm/hr, a C-reactive protein level of 11.17 g/dL, and a white blood cell count of 20.2 × 10(3)/mcL. Staphylococcus aureus, Candida albicans, and Pseudomonas aeruginosa were cultured from the wounds. All cases were treated operatively with irrigation and debridement and with antimicrobial therapy. Patients received antibiotics for an average of 6 weeks. Conclusion. Septic arthritis of the shoulder occurs in all pediatric ages. Successful treatment of septic arthritis of the shoulder was accomplished in four cases without division of the biceps sheath, with an average follow-up of 8 months.

摘要

背景。小儿人群(<18岁)肩肱关节的化脓性关节炎在文献中并不常见。关于其临床表现和治疗的信息相应较少。方法。完成了一项经机构审查委员会批准的对骨科接受冲洗和清创治疗患者的回顾性研究。这项回顾性研究纳入了2005年至2015年间出现肩部化脓性关节炎的4例患者。结果。就诊时的平均年龄为5岁,范围为1个月至15岁。患者平均在7天后出现疼痛,平均体温为39°C,红细胞沉降率为66毫米/小时,C反应蛋白水平为11.17克/分升,白细胞计数为20.2×10³/微升。从伤口培养出金黄色葡萄球菌、白色念珠菌和铜绿假单胞菌。所有病例均接受了冲洗和清创手术及抗菌治疗。患者平均接受了6周的抗生素治疗。结论。肩部化脓性关节炎发生于所有小儿年龄段。4例肩部化脓性关节炎患者在未切开肱二头肌腱鞘的情况下成功治愈,平均随访8个月。

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