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儿童膝关节化脓性关节炎:批判性分析综述。

Septic Arthritis of the Knee in Children: A Critical Analysis Review.

机构信息

UCSF Benioff Children's Hospital, Oakland, California.

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

出版信息

JBJS Rev. 2020 Jan;8(1):e0069. doi: 10.2106/JBJS.RVW.19.00069.

Abstract

» Septic arthritis of the knee is the most common type of septic arthritis in children, and it may result in irreversible joint damage. » Staphylococcus aureus is the most common pathogen associated with septic arthritis, but other causative pathogens are possible in children with certain risk factors. » The diagnosis of septic arthritis of the knee is based on history and physical examination, blood tests, and arthrocentesis. » Empiric treatment with anti-staphylococcal penicillin or a first-generation cephalosporin is usually recommended but may be tailored according to local resistance patterns and clinical culture data. » Open or arthroscopic surgical debridement including extensive lavage is effective in eradicating infection, and most patients do not require additional surgical intervention.

摘要

膝关节化脓性关节炎是儿童中最常见的化脓性关节炎类型,可能导致不可逆转的关节损伤。金黄色葡萄球菌是与化脓性关节炎最相关的最常见病原体,但在具有某些危险因素的儿童中,其他病原体也可能导致该病。膝关节化脓性关节炎的诊断基于病史和体格检查、血液检查和关节穿刺。通常建议经验性使用抗葡萄球菌青霉素或第一代头孢菌素进行治疗,但可根据当地耐药模式和临床培养数据进行调整。开放性或关节镜下清创术包括广泛冲洗可有效消除感染,大多数患者无需进一步手术干预。

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