Sakamoto Akio, Chigusa Yoshitsugu, Noguchi Takashi, Matsuda Shuichi
Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan.
Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan.
J Bone Jt Infect. 2020 Jul 13;6(1):1-5. doi: 10.5194/jbji-6-1-2020. eCollection 2020.
Although characteristic, is a rare cause of osteomyelitis, especially in healthy individuals. A 25-year old primigravida at 29 weeks' gestation noticed pain and swelling in her right wrist. Her leukocyte count was normal, but her C-reactive protein level was slightly elevated, at 1.1 mg dL (normal range, mg dL ). Plain radiography showed an osteolytic lesion in the distal radius, and magnetic resonance imaging (MRI) showed an extraosseous fluid collection with bone edema in addition to the osseous lesion. After a needle biopsy was performed, the skin overlying the lesion became ulcerated at the site of the needle tract. We drained whitish pus from the site; both this pus and the original biopsy specimen grew on culture. We diagnosed osteomyelitis and began intravenous antibiotic therapy, avoiding oral quinolones to prevent fetotoxicity. Her symptoms resolved, as did the bone edema and fluid collection. Ossification occurred at the site of osteolysis, with localized abnormal signal intensity persisting on MRI. This rare case of osteomyelitis was treated without surgery; the patient's pregnancy influenced the treatment course.
尽管具有特征性,但[疾病名称]是骨髓炎的罕见病因,尤其是在健康个体中。一名25岁初产妇,孕29周,发现右腕疼痛和肿胀。她的白细胞计数正常,但C反应蛋白水平略有升高,为1.1mg/dL(正常范围,[正常范围数值]mg/dL)。X线平片显示桡骨远端有骨质溶解病变,磁共振成像(MRI)显示除骨质病变外,还有骨外液体积聚伴骨水肿。在进行针吸活检后,病变上方的皮肤在针道部位发生溃疡。我们从该部位引出白色脓液;脓液和原始活检标本在培养时均培养出[培养出的病原体名称]。我们诊断为[疾病名称]骨髓炎,并开始静脉抗生素治疗,避免使用口服喹诺酮类药物以防止胎儿毒性。她的症状、骨水肿和液体积聚均消失。骨质溶解部位发生骨化,MRI上仍有局部异常信号强度。这例罕见的[疾病名称]骨髓炎未进行手术治疗;患者的妊娠影响了治疗过程。