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儿童自发性肩胛下脓肿的文献综述及病例报告

Literature review and a case report of spontaneous subscapular abscess in a child.

作者信息

Mourkus Hany, Vadivelu Ramanan, Phillips James

机构信息

Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.

出版信息

Eur J Orthop Surg Traumatol. 2018 Aug;28(6):1235-1240. doi: 10.1007/s00590-018-2156-4. Epub 2018 Feb 10.

DOI:10.1007/s00590-018-2156-4
PMID:29428985
Abstract

Subscapular space is an uncommon site for abscess formation. There are only seven reports of subscapular abscesses in the literature. Only three of these cases are reported in children. We recently treated a child with subscapular abscess. We performed the literature search using a combination of the keywords: subscapular, scapular, abscess and infection. One case was diagnosed on post-mortem autopsy, and only three of these cases are reported in children. The organism was Staphylococcus aureus in five cases (two were methicillin-resistant S. aureus), Haemophilus influenzae in one case, and no organism was grown in the last case. (Patient received a course of empirical antibiotics and samples did not grow any organism.) We describe a case of spontaneous subscapular abscess in a 7-year-old boy. The abscess was visualised on magnetic resonance imaging (MRI), and the organism was identified as S. aureus bacteria. The abscess was treated surgically with debridement and antibiotics, and the patient had full recovery with no subsequent effects. Subscapular abscess needs high index of suspicion and early imaging investigation. MRI is the modality of choice for accurate diagnosis. Early intervention leads to favourable outcome, while delays in diagnosis can be fatal.

摘要

肩胛下间隙是脓肿形成的罕见部位。文献中仅有7例肩胛下脓肿的报道。其中仅有3例为儿童病例。我们最近治疗了一名患有肩胛下脓肿的儿童。我们使用“肩胛下”“肩胛骨”“脓肿”和“感染”等关键词组合进行了文献检索。1例在尸检时被诊断,其中仅有3例为儿童病例。5例的病原体为金黄色葡萄球菌(2例为耐甲氧西林金黄色葡萄球菌),1例为流感嗜血杆菌,最后1例未培养出病原体(患者接受了经验性抗生素疗程,样本未培养出任何病原体)。我们描述了一名7岁男孩自发性肩胛下脓肿的病例。脓肿在磁共振成像(MRI)上显影,病原体被鉴定为金黄色葡萄球菌。脓肿通过清创术和抗生素进行手术治疗,患者完全康复且无后续影响。肩胛下脓肿需要高度怀疑并尽早进行影像学检查。MRI是准确诊断的首选检查方式。早期干预可带来良好预后,而诊断延迟可能是致命的。

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本文引用的文献

1
A Posterolateral Approach to the Scapula for Evacuation of a Subscapular Abscess: A Case Report.一种用于肩胛下脓肿引流的肩胛骨后外侧入路:病例报告
JBJS Case Connect. 2017 Jul-Sep;7(3):e57. doi: 10.2106/JBJS.CC.16.00241.
2
Subscapular Abscess in a Nine-Year-Old Female Patient: A Case Report.一名九岁女性患者的肩胛下脓肿:病例报告
JBJS Case Connect. 2015 Jan-Mar;5(1):e13. doi: 10.2106/JBJS.CC.N.00102.
3
A giant scapular aneurysmal bone cyst in a child.一名儿童的巨大肩胛骨动脉瘤样骨囊肿。
那里有吗?一例糖尿病患者非创伤性自发性胸锁乳突肌脓肿。
Am J Case Rep. 2023 Dec 19;24:e942265. doi: 10.12659/AJCR.942265.
4
Dorsal subscapularis approach for the surgical drainage of subscapularis intramuscular abscess: a case report.肩胛下肌肌内脓肿的手术引流:肩胛下肌后入路:病例报告。
BMC Musculoskelet Disord. 2019 Oct 12;20(1):445. doi: 10.1186/s12891-019-2852-1.
Case Rep Orthop. 2012;2012:327023. doi: 10.1155/2012/327023. Epub 2012 May 17.
4
Subscapular abscess after blunt trauma.钝性创伤后肩胛下脓肿
Pediatr Emerg Care. 2009 Jun;25(6):399-400. doi: 10.1097/PEC.0b013e3181a7927d.
5
Spontaneous subscapular abscess: a rare surgical condition.自发性肩胛下脓肿:一种罕见的外科病症。
Heart Lung Circ. 2008 Dec;17(6):517-8. doi: 10.1016/j.hlc.2007.02.095. Epub 2007 Apr 6.
6
Tumors of the shoulder girdle: a review of 194 cases.肩胛带肿瘤:194例病例回顾
J Shoulder Elbow Surg. 2005 Sep-Oct;14(5):460-5. doi: 10.1016/j.jse.2005.02.003.
7
Spontaneous septic subscapular abscess. A case report.自发性脓毒性肩胛下脓肿。病例报告。
J Bone Joint Surg Am. 2004 Jun;86(6):1302-4. doi: 10.2106/00004623-200406000-00028.
8
Subscapular abscess due to Haemophilus influenzae type B.由B型流感嗜血杆菌引起的肩胛下脓肿。
Pediatrics. 1980 Feb;65(2):331-2.
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Fatal subscapular staphylococcal abscess.致命性肩胛下葡萄球菌脓肿
South Med J. 1983 Feb;76(2):271. doi: 10.1097/00007611-198302000-00039.