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人工关节感染:病例报告及文献综述

Prosthetic joint infection by : Case report and a review of the literature.

作者信息

Fernandez-Pittol Mariana, Bosch Jordi, Morata Laura, Lozano Luis, Martínez Pastor Juan Carlos, Soriano Alex

机构信息

Department of Microbiology, Hospital Clínic, University of Barcelona, Barcelona, Spain.

Barcelona Institute for Global health (ISGlobal), Universitat de Barcelona, Barcelona, Spain.

出版信息

Int J Artif Organs. 2020 Mar 24:391398820912746. doi: 10.1177/0391398820912746.

Abstract

INTRODUCTION

is a Gram-negative coccobacillus involved in different infections mostly described in case reports. Prosthetic joint infections in relation to this pathogen are rare. Here, we present the third case of in a patient without anatomical or functional spleen dysfunction.

CASE REPORT

The patient was a 62-year-old female with a total knee prosthesis implanted in 1997 that required multiple replacements of the femoral component due to aseptic loosening in the past years. The patient was admitted to our hospital for an elective replacement surgery due to new radiological signs of loosening. was isolated from synovial fluid obtained during surgery. The identification was performed by matrix-assisted laser desorption ionization-time of flight mass spectrometry and confirmed by 16S rRNA gene amplification and sequencing. Antibiotic treatment was started but 14 days after surgery the patient presented pain and joint effusion. An arthrocentesis was performed and synovial fluid culture was positive again for Surgical debridement including polyethylene replacement was performed and antibiotic treatment was continued for 3 months. After a 2-year follow-up period, the patient remained asymptomatic and physical examination showed normal function of the prosthesis.

CONCLUSION

is an uncommon cause of bone and joint infections. This case indicates that this microorganism is a potential pathogen of prosthetic or native arthritis, and it should be considered when cultures are negative and in cases presenting torpid evolution.

摘要

引言

[具体细菌名称未给出]是一种革兰氏阴性球杆菌,涉及不同感染,大多在病例报告中有描述。与这种病原体相关的人工关节感染很罕见。在此,我们报告第三例发生在无解剖学或功能性脾脏功能障碍患者中的[具体细菌名称未给出]感染病例。

病例报告

该患者为一名62岁女性,1997年植入全膝关节假体,由于过去几年无菌性松动,股骨部件需要多次更换。因出现新的影像学松动迹象,患者入院接受择期置换手术。手术中获取的滑液分离出了[具体细菌名称未给出]。通过基质辅助激光解吸电离飞行时间质谱进行鉴定,并通过16S rRNA基因扩增和测序得以确认。开始进行抗生素治疗,但术后14天患者出现疼痛和关节积液。进行了关节穿刺,滑液培养再次显示[具体细菌名称未给出]阳性。进行了包括聚乙烯置换在内的手术清创,并继续抗生素治疗3个月。经过2年随访期,患者无症状,体格检查显示假体功能正常。

结论

[具体细菌名称未给出]是骨与关节感染的罕见病因。该病例表明这种微生物是人工关节或天然关节关节炎的潜在病原体,在培养结果为阴性以及病情进展缓慢的病例中应予以考虑。

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