Le Hanneur M, Vidal C, Mallet C, Mazda K, Ilharreborde B
Département d'orthopédie pédiatrique, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France.
Département d'orthopédie pédiatrique, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France.
Orthop Traumatol Surg Res. 2016 Nov;102(7):959-961. doi: 10.1016/j.otsr.2016.05.019. Epub 2016 Sep 14.
A 32-month-old boy presented with febrile limping that had developed over 6days, associated with right lumbosacral inflammatory swelling. Magnetic resonance imaging (MRI) showed joint effusion of the right L5-S1 zygapophyseal joint, complicated by destructive osteomyelitis of the L5 articular process and paraspinal abscess. Surgery was decided to evacuate the fluid accumulation and rule out differential diagnoses. The diagnosis of septic arthritis of the facet joint was confirmed intraoperatively; real-time quantitative PCR analysis identified Kingella kingae. This is the first substantiated paediatric case of zygapophyseal joint septic arthritis due to K. kingae. K. kingae is the most common pathogen responsible for invasive osteoarticular infection in children under 4years of age. Since empiric antibiotics are effective in early stages, physicians should consider the possibility of spinal infections due to K. kingae when a limping child under 4years of age presents with a fever.
一名32个月大的男孩出现发热性跛行，病程6天，伴有右腰骶部炎性肿胀。磁共振成像（MRI）显示右L5-S1关节突关节积液，并伴有L5关节突破坏性骨髓炎和椎旁脓肿。决定进行手术以清除积液并排除鉴别诊断。术中确诊为小关节化脓性关节炎；实时定量PCR分析鉴定为金氏金杆菌。这是首例经证实的由金氏金杆菌引起的小儿关节突关节化脓性关节炎病例。金氏金杆菌是4岁以下儿童侵袭性骨关节炎感染最常见的病原体。由于经验性抗生素在早期有效，当4岁以下跛行儿童出现发热时，医生应考虑金氏金杆菌引起脊柱感染的可能性。
