Internal Medicine, Infectious Diseases, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Internal Medicine, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
BMJ Case Rep. 2022 Mar 10;15(3):e248240. doi: 10.1136/bcr-2021-248240.
A woman in her 60s with a left hip prosthesis was presented with left hip pain and fever. She had an elevated white blood cell count and inflammatory markers. Synovial fluid Gram stain demonstrated curved Gram-negative rods identified as The patient initially refused surgery and after 3 months underwent one-stage exchange after which she was treated with 12 weeks of levofloxacin. Her inflammatory markers normalised and she was clinically doing well at her 6-month follow-up. is a rare cause of prosthetic joint infection and should be included in the differential diagnosis when a patient has risk factors even without significant preceding gastrointestinal symptoms. Per most recent Infectious Diseases Society of America guidelines, treatment after one-stage revision includes 4-6 weeks of intravenous antimicrobials followed by possible oral suppression therapy, while the European guidelines recommend 12 weeks of orally bioavailable antibiotics.
一位 60 多岁的女性，左侧髋关节假体，出现左侧髋关节疼痛和发热。她的白细胞计数和炎症标志物升高。关节滑液革兰氏染色显示弯曲的革兰氏阴性杆菌，鉴定为 患者最初拒绝手术，3 个月后进行了一期翻修，之后接受了 12 周左氧氟沙星治疗。她的炎症标志物恢复正常，在 6 个月的随访时临床状况良好。 是假体关节感染的罕见病因，当患者存在危险因素（即使没有明显的胃肠道前驱症状）时，应包括在鉴别诊断中。根据最近的美国传染病学会指南，一期翻修后治疗包括 4-6 周的静脉用抗生素，然后可能进行口服抑制治疗，而欧洲指南建议使用 12 周口服生物利用度抗生素。
