Barrientos Cristian, Barahona Maximiliano, Olivares Rodrigo
Orthopaedic Department at Hospital Clinico Universidad de Chile, Santos Dumontt 999, Santiago, Chile.
Case Rep Orthop. 2017;2017:6732318. doi: 10.1155/2017/6732318. Epub 2017 Nov 14.
A case report of a 65-year-old female with a history of right total hip arthroplasty (THA) in 2007 and left THA in 2009 was presented. She consulted with our institution for the first time, on December 2013, for right hip pain and fistula on the THA incision. It was managed as a chronic infection, so a two-stage revision was performed. First-time intraoperative cultures were positive for (3/5) and (2/5). Three weeks after the second half of the review, it evolved with acute fever and pain in relation to right hip. No antibiotics were used, arthrocentesis was performed, and a coagulase-negative staphylococci multisensible was isolated at the 5th day. Since the germ was different from the first revision, it was decided to perform a one-stage revision. One year after the first review, the patient has no local signs of infection and presents ESV and RPC in normal limits. The indication and management of periprosthetic infections are discussed.
报告了一例65岁女性病例，该患者在2007年接受了右全髋关节置换术（THA），2009年接受了左THA。2013年12月，她首次因右髋关节疼痛和THA切口处瘘管前来我院就诊。该病例被诊断为慢性感染，因此进行了两阶段翻修手术。首次术中培养结果显示，[具体细菌1]阳性（5份样本中3份），[具体细菌2]阳性（5份样本中2份）。在二期翻修术后三周，患者出现急性发热和右髋关节疼痛。未使用抗生素，进行了关节穿刺，在第5天分离出一株多重敏感的凝固酶阴性葡萄球菌。由于该病菌与首次翻修时不同，决定进行一期翻修手术。首次翻修术后一年，患者无局部感染迹象，血沉（ESV）和红细胞沉降率（RPC）均在正常范围内。文中讨论了假体周围感染的指征和处理方法。
