骨与关节感染。
Bone and joint infection.
机构信息
Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
出版信息
Clin Med (Lond). 2018 Mar;18(2):150-154. doi: 10.7861/clinmedicine.18-2-150.
Bone and joint infections include septic arthritis, prosthetic joint infections, osteomyelitis, spinal infections (discitis, vertebral osteomyelitis and epidural abscess) and diabetic foot osteomyelitis. All of these may present through the acute medical take. This article discusses the pathogenesis of infection and highlights the importance of taking a careful history and fully examining the patient. It also emphasises the importance of early surgical intervention in many cases. Consideration of alternative diagnoses, appropriate imaging and high-quality microbiological sampling is important to allow appropriate and targeted antimicrobial therapy. This article makes some suggestions as to empiric antibiotic choice; however, therapy should be guided by local antimicrobial policies and infection specialists. Involvement of a multidisciplinary team is essential for optimal outcomes.
骨与关节感染包括化脓性关节炎、人工关节感染、骨髓炎、脊柱感染（椎间盘炎、椎体骨髓炎和硬膜外脓肿）和糖尿病足骨髓炎。所有这些都可能通过急性医疗就诊出现。本文讨论了感染的发病机制，并强调了仔细询问病史和全面检查患者的重要性。它还强调了在许多情况下早期手术干预的重要性。考虑其他诊断、适当的影像学检查和高质量的微生物取样对于进行适当和有针对性的抗菌治疗很重要。本文就经验性抗生素选择提出了一些建议；然而，治疗应根据当地的抗菌政策和感染专家的意见来指导。多学科团队的参与对于获得最佳结果至关重要。
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