中国首例由艰难梭菌引起的人工关节感染病例。
First case of periprosthetic joint infection due to Clostridioides difficile in China.
机构信息
Department of Orthopaedic, Jishuitan Hospital and Fourth Medical College of Peking University, Beijing, China.
Department of Microbiology and Molecule Laboratory, Jishuitan Hospital and Fourth Medical College of Peking University, 31 East Street, Xinjiekou, Xicheng District, Beijing, 100035, CN, China.
出版信息
BMC Infect Dis. 2021 May 21;21(1):462. doi: 10.1186/s12879-021-06171-y.
BACKGROUND
Clostridioides difficile usually causes intestinal infections. However, a 75-year-old lady had a periprosthetic joint infection due to this microorganism. We report a C. difficile infection of a prosthetic hip joint. Such an infection is rarely reported around the world.
CASE PRESENTATION
The elder female patient presented with a 2-year history of right hip pain with movement restriction. Her right leg was shorter than another. The skin around the right hip joint was red and swollen without sinus. Her lab test result showed elevator ESR and CRP. Her X-ray film showed a massive bone defect. The patient had a total hip arthroplasty 16 years ago and had a revision 5 years ago. During this hospitalization, her cultures of the synovial fluid and tissue repeatedly grew C. difficile. She improved following two-stage revision surgery and antibiotic treatment. The patient has no recurrence of infection after a one-year follow-up.
CONCLUSION
A rapid and accurate sample collection is significant for culture results, making an outstanding contribution to the successful treatment.
背景
艰难梭菌通常会引起肠道感染。然而，一位 75 岁的女士因该微生物引起了假体关节感染。我们报告了一例人工髋关节的艰难梭菌感染。这种感染在世界范围内很少见。
病例介绍
这位老年女性患者右髋关节疼痛伴活动受限已有 2 年病史。她的右腿比另一条腿短。右髋关节周围的皮肤红肿，无窦道。她的实验室检查结果显示红细胞沉降率和 C 反应蛋白升高。她的 X 光片显示严重的骨缺损。患者 16 年前曾行全髋关节置换术，5 年前行翻修术。在此住院期间，其关节液和组织的培养结果反复检出艰难梭菌。经两阶段翻修手术和抗生素治疗后，患者病情得到改善。患者在随访 1 年后无感染复发。
结论
快速准确的样本采集对培养结果非常重要，为成功治疗做出了突出贡献。
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