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由杀白细胞素阳性的泛耐药性金黄色葡萄球菌引起的肩胛下脓肿:一种非典型表现。

Subscapular Abscess Caused by Panton-Valentine Leukocidin-Positive : An Atypical Presentation.

作者信息

Patel Kamal, Spowart Emma, Sochorova Dana, Diego Nadia, Mamarelis Georgios, Sohail Mohammad Zain

机构信息

Accident and Emergency Department, Barnet Hospital, Royal Free London NHS Foundation Trust, Wellhouse Lane, Barnet EN5 3DJ, UK.

Bart's Health NHS Foundation Trust, London, UK.

出版信息

Case Rep Orthop. 2018 Jun 10;2018:8256428. doi: 10.1155/2018/8256428. eCollection 2018.

Abstract

Subscapular abscess is an uncommon condition which requires early recognition followed by prompt surgical intervention. We present a case of spontaneous subscapular abscess following blunt trauma to the shoulder in a patient with a history of recurrent superficial soft tissue infections, in which Panton-Valentine leukocidin-producing was identified as the infectious agent. This strain due to its virulence can lead to fatal infections in otherwise healthy individuals; therefore, a high index of suspicion is needed to investigate with an MRI to rule out abscess formation in a patient with acute shoulder girdle pain and negative joint aspirate. Urgent surgical intervention and targeted antimicrobial therapy against PVL-positive in accordance with microbiologist yield good outcomes.

摘要

肩胛下脓肿是一种罕见病症,需要早期识别并及时进行手术干预。我们报告一例有反复浅表软组织感染病史的患者,在肩部钝性创伤后发生自发性肩胛下脓肿,其中鉴定出产生杀白细胞素的潘顿-瓦伦丁(Panton-Valentine)菌为感染病原体。该菌株因其毒力可导致原本健康的个体发生致命感染;因此,对于急性肩带疼痛且关节穿刺阴性的患者,需要高度怀疑并通过磁共振成像(MRI)检查以排除脓肿形成。根据微生物学家的建议,紧急进行手术干预并针对产PVL阳性菌进行靶向抗菌治疗可取得良好效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/534b/6015668/a571d13ae9da/CRIOR2018-8256428.001.jpg

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