Skedros John G, Adondakis Micheal G, Brown Eric M, Oliver Marquam R
Utah Orthopaedic Specialists, Murray, Utah, USA.
Tufts University School of Medicine, Boston, Massachusetts, USA.
BMJ Case Rep. 2018 Feb 12;2018:bcr-2017-223782. doi: 10.1136/bcr-2017-223782.
This report describes a 63-year-old generally healthy male with septic olecranon bursitis caused by The patient sustained a small laceration after striking the posterior aspect of his left elbow on a metal railing when he was at a public swimming pool. We concluded that was not initially detected because cultures were only kept for 5 days. Consequently, initial antibiotic treatment failed. and grew in a subsequent tissue culture. The infection did not respond to intravenous vancomycin although soft-tissue debridements were done. This likely reflected the presence of olecranon osteomyelitis (seen on MRI scans) in addition to inadequate treatment with this antibiotic in the setting of a polymicrobial infection. Eventually, the infection was eradicated with multiple soft-tissue debridements in addition to the continuation of vancomycin with daily intravenous piperacillin/tazobactam that was added for the final 4 weeks of antibiotic treatment.
本报告描述了一名63岁的一般健康男性，患有由[具体病因未给出]引起的感染性鹰嘴滑囊炎。患者在公共游泳池时，左肘部后侧撞到金属栏杆后受了一处小伤口。我们得出结论，[具体病菌未给出]最初未被检测到是因为培养物仅保存了5天。因此，初始抗生素治疗失败。[具体病菌未给出]在随后的组织培养中生长。尽管进行了软组织清创术，但感染对静脉注射万古霉素无反应。这可能反映了除了在多微生物感染情况下使用这种抗生素治疗不足外，还存在鹰嘴骨髓炎（MRI扫描显示）。最终，除了继续使用万古霉素外，还通过多次软组织清创术根除了感染，在抗生素治疗的最后4周每天静脉注射哌拉西林/他唑巴坦。
