Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
BMJ Case Rep. 2020 Sep 29;13(9):e236350. doi: 10.1136/bcr-2020-236350.
A 72-year-old man with a history of right reverse shoulder arthroplasty presented with a 1-month history of erythema, pain and drainage from the right shoulder. Arthrocentesis was performed and synovial fluid gram stain revealed gram-positive rods. Clinical diagnosis of prosthetic shoulder joint infection was made. Orthopaedic surgeons performed irrigation and debridement with resection of the right shoulder prothesis and implantation of an antimicrobial spacer. Operative cultures grew The patient was treated with 6 weeks of ceftriaxone with improvement in both clinical symptoms and laboratory values. species remain a rare cause of late prosthetic joint infection (PJI) due to their slow growing and indolent course. While generalised actinomycosis is often treated with 6-12 months of antibiotics, the treatment course of PJI is not well characterised, with some sources suggesting a minimum of 6 weeks of antimicrobial therapy.
一位 72 岁男性,既往有右侧反式肩关节置换术史,因右侧肩部红斑、疼痛伴渗液 1 个月就诊。行关节穿刺,关节液革兰氏染色显示革兰阳性杆菌。临床诊断为人工关节肩关节感染。骨科医生行灌洗清创术,切除右侧肩关节假体并植入抗菌间隔物。手术培养出 种。患者接受了 6 周头孢曲松治疗,临床症状和实验室指标均有所改善。 种仍为罕见的迟发性人工关节感染(PJI)病因,因其生长缓慢且呈惰性病程。虽然全身性放线菌病通常采用 6-12 个月的抗生素治疗,但 PJI 的治疗疗程尚未明确,一些资料提示至少需要 6 周的抗菌治疗。