Ross John J
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 15 Francis Street, PBB-B420, Boston, MA 02115, USA.
Infect Dis Clin North Am. 2017 Jun;31(2):203-218. doi: 10.1016/j.idc.2017.01.001. Epub 2017 Mar 30.
Septic arthritis is a rheumatologic emergency that may lead to disability or death. Prompt evacuation of the joint, either by arthrocentesis at the bedside, open or arthroscopic drainage in the operating room, or imaging-guided drainage in the radiology suite, is mandatory. Methicillin-resistant Staphylococcus aureus (MRSA) has become a major cause of septic arthritis in the United States. MRSA joint infection seems to be associated with worse outcomes. Antibiotic courses of 3 to 4 weeks in duration are usually adequate for uncomplicated bacterial arthritis. Treatment duration should be extended to 6 weeks if there is imaging evidence of accompanying osteomyelitis.
化脓性关节炎是一种风湿性急症,可能导致残疾或死亡。必须迅速对关节进行引流,可通过床边关节穿刺、在手术室进行开放或关节镜引流,或在放射科进行影像引导下引流。耐甲氧西林金黄色葡萄球菌(MRSA)已成为美国化脓性关节炎的主要病因。MRSA关节感染似乎与更差的预后相关。对于无并发症的细菌性关节炎,通常3至4周的抗生素疗程就足够了。如果有影像学证据表明伴有骨髓炎,治疗疗程应延长至6周。