产气荚膜梭菌致胸锁关节化脓性关节炎。
Clostridium Perfringens Septic Arthritis of the Sternoclavicular Joint.
机构信息
Department of Emergency Medicine, University Hospital Waterford, Waterford, Republic of Ireland.
出版信息
J Emerg Med. 2021 Aug;61(2):169-171. doi: 10.1016/j.jemermed.2021.03.001. Epub 2021 May 13.
BACKGROUND
Clostridium perfringens septic arthritis of the sternoclavicular joint has not been reported previously.
CASE REPORT
We present the case of a 70-year-old patient with a history of stage IV colon cancer who presented to the emergency department with chest and neck pain for 3 days. After assessment, he was discharged home on analgesics. Within 24 h he returned, critically ill with C. perfringens septic arthritis of the left sternoclavicular joint and septic shock. Why Should an Emergency Physician Be Aware of This? Emergency physicians should be aware of the possibility of C. perfringens sternoclavicular joint septic arthritis in patients with unexplained chest, shoulder, or neck pain, especially when associated with a history of colorectal carcinoma or immunosuppression. A finding of C. perfringens bacteremia should prompt a search for occult gastrointestinal malignancy.
背景
产气荚膜梭菌性胸骨锁骨关节炎此前未有报道。
病例报告
我们报告了一例 70 岁的 IV 期结肠癌患者，他因胸痛和颈部疼痛 3 天到急诊科就诊。评估后，他在家中服用止痛药后出院。24 小时内，他因左胸骨锁骨关节产气荚膜梭菌性化脓性关节炎和感染性休克而病重返回。
为什么急诊医生应该了解这个？
急诊医生应注意到不明原因的胸痛、肩部或颈部疼痛的患者中存在产气荚膜梭菌性胸骨锁骨关节炎的可能性，特别是当伴有结直肠癌病史或免疫抑制时。产气荚膜梭菌菌血症的发现应促使寻找隐匿性胃肠道恶性肿瘤。
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