Moon Jeong-Bo, Lee Jun-Hwan, Ryu Byung-Ju
Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul, Korea.
J Yeungnam Med Sci. 2023 Apr;40(2):193-197. doi: 10.12701/yujm.2021.01613. Epub 2022 Jan 13.
Klebsiella pneumoniae is an uncommon cause of septic arthritis in adults. However, late detection can cause serious complications, including joint destruction and immobility. The purpose of this study was to report a case of successfully treated septic arthritis of the hip joint (SAHJ) caused by K. pneumoniae. A 49-year-old female patient presented to our hospital with fever and progressive severe pain in the right hip area. Although there was no abnormality on plain radiographs, ultrasonography revealed diffuse swelling of the right hip joint. Under ultrasonography guidance, the hip joint fluid was aspirated, and Gram staining and culturing were performed. The patient's pain was significantly reduced after the joint aspiration. The Gram staining and culturing revealed gram-negative bacilli, which were subsequently identified as K. pneumoniae. According to the results, systemic intravenous antibiotic (ceftriaxone) was administered without complications, and the patient was discharged on oral antibiotic (ciprofloxacin). Clinical cases of septic arthritis of the knee or sacroiliac joint have been occasionally reported in adults, but cases of SAHJ are rare. Moreover, K. pneumonia-induced SAHJ has not been reported to date. Therefore, we report this very rare case and its successful treatment.
肺炎克雷伯菌是成人感染性关节炎的罕见病因。然而，检测延迟会导致严重并发症，包括关节破坏和活动障碍。本研究旨在报告一例由肺炎克雷伯菌引起的髋关节感染性关节炎（SAHJ）并成功治愈的病例。一名49岁女性患者因发热和右髋部进行性剧痛前来我院就诊。尽管X线平片未见异常，但超声检查显示右髋关节弥漫性肿胀。在超声引导下，抽取髋关节液并进行革兰氏染色和培养。关节穿刺后患者疼痛明显减轻。革兰氏染色和培养显示革兰氏阴性杆菌，随后鉴定为肺炎克雷伯菌。根据检查结果，给予全身静脉抗生素（头孢曲松）治疗，未出现并发症，患者出院时口服抗生素（环丙沙星）。成人膝关节或骶髂关节感染性关节炎的临床病例偶尔有报道，但SAHJ病例罕见。此外，迄今为止尚未有肺炎克雷伯菌引起SAHJ的报道。因此，我们报告这一极为罕见的病例及其成功治疗过程。
