Pääkkönen Markus
Department of Pediatric Orthopaedic Surgery.
Department of Hand Surgery, Turku University Hospital and the University of Turku, Turku, Finland.
Pediatric Health Med Ther. 2017 May 18;8:65-68. doi: 10.2147/PHMT.S115429. eCollection 2017.
Acute septic arthritis in children is usually hematogenous. It is more common in boys, and it most often affects the large joints of the lower limb. Diagnosis is based on cultures obtained from the infected joint and is supported by C-reactive protein blood test or ultrasound imaging. is the most common causative agent and is the primary target for empiric treatment. First-generation cephalosporins and clindamycin are suitable antibiotics. Vancomycin is utilized in areas with high rates of clindamycin- and methicillin-resistant . After a short intravenous administration of 2-4 days, a total course of 2 weeks is sufficient in uncomplicated cases. Early antibiotic treatment has significantly improved the prognosis in high-income settings, but uncomplicated recovery is compromised if the treatment is delayed. Complications such as symptomatic osteoarthritis or avascular necrosis of the femoral head develop slowly. A long follow-up of 1-2 years is required to detect all possible sequelae.
儿童急性化脓性关节炎通常是血源性的。多见于男孩,最常累及下肢大关节。诊断基于从感染关节获取的培养物,并通过C反应蛋白血液检测或超声成像辅助。 是最常见的病原体,也是经验性治疗的主要靶点。第一代头孢菌素和克林霉素是合适的抗生素。在克林霉素和耐甲氧西林 发生率高的地区使用万古霉素。在进行2 - 4天的短期静脉给药后,对于无并发症的病例,2周的总疗程就足够了。在高收入地区,早期抗生素治疗显著改善了预后,但如果治疗延迟,无并发症的恢复会受到影响。症状性骨关节炎或股骨头缺血性坏死等并发症发展缓慢。需要进行1 - 2年的长期随访以检测所有可能的后遗症。