Cheong Ryan Chin Taw, Harding Laura
Broomfield Hospital, Mid Essex Hospital Services NHS Trust, Court Road, Broomfield, Chelmsford CM1 7ET, UK.
Case Rep Otolaryngol. 2017;2017:3641642. doi: 10.1155/2017/3641642. Epub 2017 Mar 28.
Septic arthritis of the temporomandibular joint (SATMJ) is a rare complication of acute otitis media (AOM) with only four reported cases in the English and Japanese literature. Based on the unusual nature of this clinical condition, we discuss the first documented case due to and the utility of myringotomy with long-term intravenous antibiotics via a peripherally inserted central catheter (PICC). We describe the case of a 76-year-old male patient that was brought in by ambulance to the accident and emergency (A&E) department due to severe right-sided otalgia with increased hearing impairment. A clinical diagnosis of acute otitis media with sepsis was made and the patient was commenced on the sepsis protocol. He then developed symptoms of septic arthritis of the TMJ which was confirmed on radiological imaging. After a multidisciplinary team discussion, the patient was treated with a myringotomy and intravenous ceftriaxone for 8 weeks in the community via a PICC rather than TMJ arthrocentesis with positive outcomes at 3 months' follow-up.
颞下颌关节化脓性关节炎（SATMJ）是急性中耳炎（AOM）的一种罕见并发症，英文和日文文献中仅报道了4例。基于这种临床情况的特殊性，我们讨论了首例有记录的病例以及通过外周静脉穿刺中心静脉导管（PICC）进行鼓膜切开术并长期静脉使用抗生素的效用。我们描述了一名76岁男性患者的病例，该患者因严重的右侧耳痛伴听力障碍加重，由救护车送往事故与急救（A&E）部门。临床诊断为急性中耳炎伴败血症，患者开始接受败血症治疗方案。随后，他出现了颞下颌关节化脓性关节炎的症状，经影像学检查得以确诊。经过多学科团队讨论，该患者在社区接受了鼓膜切开术，并通过PICC静脉注射头孢曲松8周，而非进行颞下颌关节穿刺术，在3个月的随访中取得了积极的结果。
