Koch A E
Department of Internal Medicine, Northwestern University Medical School, Chicago, IL 60611.
J Rheumatol. 1988 Feb;15(2):362-5.
A woman with rheumatoid arthritis who underwent total knee arthroplasty is described. The implant became infected with Staphylococcus epidermidis and she received a prolonged course of postoperative antistaphylococcal antibiotics. Four months postoperatively she developed a calf ulcer that grew Pseudomonas aeruginosa and required further antibiotic therapy. One year later she presented with a painful, swollen knee with radiographic findings suggesting loosening of the prosthetic knee implant. Arthrocentesis cultures grew Candida albicans. She was treated with arthrodesis, amphotericin B, 5-fluorocytosine, and ketoconazole and remains free of infection 21 months after removal of the prosthesis. The clinical course of 6 other cases of Candida prosthetic joint infections is reviewed.
本文描述了一名患有类风湿性关节炎并接受全膝关节置换术的女性患者。植入物感染了表皮葡萄球菌，她接受了术后长期的抗葡萄球菌抗生素治疗。术后四个月，她出现了小腿溃疡，培养出铜绿假单胞菌，需要进一步的抗生素治疗。一年后，她因膝关节疼痛、肿胀就诊，影像学检查结果提示人工膝关节植入物松动。关节穿刺培养出白色念珠菌。她接受了关节融合术、两性霉素B、5-氟胞嘧啶和酮康唑治疗，在假体取出21个月后仍未发生感染。本文还回顾了其他6例念珠菌性人工关节感染的临床病程。
