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“近球形德巴利酵母”——关节镜下肩袖修复术后罕见真菌性脓毒性关节炎的治疗——病例报告

"Debaryomyces subglobosus" - Management of a rare case of fungal septic arthritis post arthroscopic rotator cuff repair - a case report.

作者信息

Palasseril Aizel Sherief, Gopinath Sathya Vignes, Thanikachalam Ramakrishnan, Prabhu Sanjoo Anto, Rajamanoharan Vivek, Shahul Mymoonah Risha

机构信息

Department of Orthopaedics, Parvathy Ortho Hospital, Chennai 600044, India.

Department of Plastic Surgery, Parvathy Ortho Hospital, Chennai 600044, India.

出版信息

SICOT J. 2021;7:60. doi: 10.1051/sicotj/2021057. Epub 2021 Nov 29.

DOI:10.1051/sicotj/2021057
PMID:34851263
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8634897/
Abstract

Fungal septic arthritis of the shoulder is extremely rare in post arthroscopic rotator cuff repair patients. We report our experience in successfully identifying and managing a rare case of fungal septic arthritis with Debaryomyces subglobosus in an uncontrolled diabetic patient who underwent arthroscopic rotator cuff repair in 2019. Our patient had complete resolution of symptoms and a reasonable functional recovery within 2 months of debridement and initiation of the specific anti-fungal. This case highlights the importance of high clinical suspicion for atypical fungal infections, and the use of culture-independent modern diagnostic tools like DNA-PCR as adjuncts to successfully identify rare pathogens in immunodeficient patients presenting with vague, nonspecific symptoms of infection.

摘要

真菌性肩关节化脓性关节炎在关节镜下肩袖修复术后患者中极为罕见。我们报告了我们成功识别和处理一例罕见的由球形德巴利酵母引起的真菌性化脓性关节炎的经验，该患者为一名未控制的糖尿病患者，于2019年接受了关节镜下肩袖修复术。我们的患者在清创和开始使用特异性抗真菌药物后的2个月内症状完全缓解，功能恢复良好。该病例强调了对非典型真菌感染保持高度临床怀疑的重要性，以及使用DNA-PCR等不依赖培养的现代诊断工具作为辅助手段，以成功识别出现模糊、非特异性感染症状的免疫缺陷患者中的罕见病原体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/1cf8ed1c6a4a/sicotj-7-60-fig10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/a1670fdece66/sicotj-7-60-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/95ca10ee1cb3/sicotj-7-60-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/2460c41b2884/sicotj-7-60-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/ee69711b7948/sicotj-7-60-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/223300d02a71/sicotj-7-60-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/4fadad108eaa/sicotj-7-60-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/4dc2c2f6629d/sicotj-7-60-fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/3fe8a1c8980f/sicotj-7-60-fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/19558f08c6e0/sicotj-7-60-fig9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/1cf8ed1c6a4a/sicotj-7-60-fig10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/a1670fdece66/sicotj-7-60-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/95ca10ee1cb3/sicotj-7-60-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/2460c41b2884/sicotj-7-60-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/ee69711b7948/sicotj-7-60-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/223300d02a71/sicotj-7-60-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/4fadad108eaa/sicotj-7-60-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/4dc2c2f6629d/sicotj-7-60-fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/3fe8a1c8980f/sicotj-7-60-fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/19558f08c6e0/sicotj-7-60-fig9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a61/8634897/1cf8ed1c6a4a/sicotj-7-60-fig10.jpg

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