Fenelon Christopher, Galbraith John G, Dalton David M, Masterson Eric
Department of Orthopaedic Surgery, University Hospital Limerick, Limerick, Ireland
Department of Orthopaedic Surgery, University Hospital Limerick, Limerick, Ireland.
J Surg Case Rep. 2017 Jan 16;2017(1):rjw235. doi: 10.1093/jscr/rjw235.
A 69-year-old female with a history of bilateral total hip replacements presented with rigors, fever and sudden onset left groin pain. A pelvic X-ray showed well-fixed implants. Blood results revealed a leucocytosis (white cell count 22.3 × 10 l) and elevated C-reactive protein (211 mg/l). Ultrasound-guided aspiration of her left hip grew Streptococcus gordonii No source infection could be identified apart from a new chronic sinus infection in a left upper incisor. Following a discussion with the patient a 6-week course of intravenous ceftriaxone was started and was successful in normalizing her inflammatory markers. She was placed on long-term suppressive amoxicillin following this. Her suppressive antibiotic therapy was complicated by the development of a clostridium difficile infection and her antibiotics were changed to doxycycline. At 1-year follow-up, she was asymptomatic with no further episodes of groin pain or fever.
一名69岁有双侧全髋关节置换史的女性出现寒战、发热及突发左侧腹股沟疼痛。骨盆X线显示植入物固定良好。血液检查结果显示白细胞增多（白细胞计数22.3×10⁹/L）及C反应蛋白升高（211mg/L）。超声引导下对其左髋关节进行穿刺抽吸，培养出戈登链球菌。除左上侧切牙新出现的慢性鼻窦感染外，未发现其他感染源。与患者讨论后，开始了为期6周的静脉注射头孢曲松治疗，炎症指标恢复正常。此后她接受了长期的阿莫西林抑制性治疗。她的抑制性抗生素治疗因艰难梭菌感染而变得复杂，抗生素改为强力霉素。随访1年时，她无症状，未再出现腹股沟疼痛或发热发作。
