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胸锁关节化脓性关节炎的药物治疗:病例报告

Medical management of septic arthritis of sternoclavicular joint: A case report.

作者信息

Kwon Hea Yoon, Cha Boram, Im Jae Hyoung, Baek Ji Hyeon, Lee Jin-Soo

机构信息

Department of Internal Medicine, Inha University School of Medicine, Jung-gu, Incheon, Republic of Korea.

出版信息

Medicine (Baltimore). 2020 Oct 30;99(44):e22938. doi: 10.1097/MD.0000000000022938.

Abstract

RATIONALE

Sternoclavicular joint septic arthritis is an unusual disease in healthy adults, and Staphylococcus aureus is the most common causative pathogen. The current treatment of choice is surgery with sternoclavicular joint resection and pectoralis flap closure, especially when the disease is complicated by osteomyelitis and abscess.

PATIENT CONCERNS

Here, we report a 76-year-old woman without risk factors who visited our hospital for pain and redness, swelling on the left anterior chest wall.

DIAGNOSIS

Magnetic resonance imaging showed infectious arthritis in the left SCJ, with multiple abscess pockets at the subcutaneous layer of anterior chest wall communicating with the joint cavity. Streptococcus agalactiae was isolated from blood culture.

INTERVENTION

She was treated with 6 weeks of antibiotic therapy.

OUTCOMES

After antibiotic treatment, she was successfully treated without recurrence.

LESSONS

Besides surgery, medical treatment should also be considered for sternoclavicular joint septic arthritis, depending on patient status and the causative pathogen. Physicians should be aware of this rare disease to facilitate its prompt diagnosis and management.

摘要

理论依据

胸锁关节化脓性关节炎在健康成年人中是一种罕见疾病,金黄色葡萄球菌是最常见的致病病原体。目前的首选治疗方法是胸锁关节切除术和胸大肌皮瓣闭合术,尤其是当疾病并发骨髓炎和脓肿时。

患者情况

在此,我们报告一名76岁无危险因素的女性,因左前胸壁疼痛、发红和肿胀前来我院就诊。

诊断

磁共振成像显示左胸锁关节感染性关节炎,前胸壁皮下层有多个脓肿腔与关节腔相通。血培养分离出无乳链球菌。

干预措施

她接受了6周的抗生素治疗。

结果

抗生素治疗后,她成功治愈,未复发。

经验教训

对于胸锁关节化脓性关节炎,除手术治疗外,还应根据患者状况和致病病原体考虑药物治疗。医生应了解这种罕见疾病,以便及时诊断和处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d05/7598876/cdec46cbaaa9/medi-99-e22938-g001.jpg

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