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一例假体关节感染患者经非手术治疗(无需取出假体或关节清创术)成功治愈。

A case of prosthetic joint infection successfully treated medically without prosthesis explantation or joint debridement.

机构信息

Infectious Diseases, University of Miami School of Medicine, Miami, Florida, USA

Infectious Diseases, Jackson Memorial Hospital, Miami, Florida, USA.

出版信息

BMJ Case Rep. 2021 Aug 17;14(8):e243675. doi: 10.1136/bcr-2021-243675.

Abstract

A 58-year-old man with a history of end-stage degenerative joint disease developed a postsurgical infection at the right hip 4 weeks after hip replacement surgery. He underwent surgical washout of the right hip without opening the joint capsule. Arthrocentesis returned positive for He was started on antibiotics with the recommendation to remove the prosthesis. The prosthesis was retained. Based on antimicrobial susceptibilities, he was treated with 4 weeks of intravenous therapy using cefoxitin and amikacin and later switched to oral ciprofloxacin and doxycycline for 5 additional months. Eighteen months from his initial hip replacement surgery, he continues to do well. Joint aspiration culture is important to make a diagnosis of prosthetic joint infection (PJI) when periprosthetic culture is not available. In the absence of serious systemic or comorbid joint conditions, PJI due to can be managed medically without having to remove the prosthesis or debride the joint.

摘要

一位 58 岁的男性,患有终末期退行性关节病,在髋关节置换手术后 4 周时出现右侧髋关节术后感染。他接受了右侧髋关节冲洗术,但未打开关节囊。关节穿刺术结果呈阳性。他开始接受抗生素治疗,并建议取出假体。但保留了假体。根据抗菌药物敏感性,他接受了 4 周的头孢西丁和阿米卡星静脉治疗,后来改为口服环丙沙星和多西环素治疗 5 个月。初次髋关节置换手术后 18 个月,他恢复良好。当无法获得假体周围培养物时,关节抽吸培养对于诊断假体关节感染(PJI)非常重要。在没有严重的全身或合并关节疾病的情况下,由于 引起的 PJI 可以通过药物治疗来管理,而无需取出假体或清创关节。

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Diagnosis and Prevention of Periprosthetic Joint Infections.人工关节周围感染的诊断与预防。
J Am Acad Orthop Surg. 2020 Apr 15;28(8):e340-e348. doi: 10.5435/JAAOS-D-19-00405.

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