Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.
Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
BMJ Case Rep. 2022 Apr 19;15(4):e249337. doi: 10.1136/bcr-2022-249337.
A man in his late 70s presented to the emergency department endorsing a week of malaise. He was recently hospitalised for 2 days for new back pain and was discharged with non-opioid pain medications but continued to seek care as he felt unwell. On presentation, he was afebrile with a leukocytosis. Physical examination revealed a painful left knee with no evidence of trauma. Arthrocentesis revealed purulent fluid with elevated white blood cell consistent with septic arthritis. He was started on broad-spectrum antibiotics and underwent irrigation and synovectomy of the left knee. Aspirate and blood cultures grew Transthoracic echocardiogram showed no vegetations; however, an MRI of lumbar spine showed L2-L3 and L4-L5 osteomyelitis. He was treated with intravenous ceftriaxone for 3 weeks and then oral levofloxacin for 3 weeks, for a total 6 week course of antibiotics.
一位 70 多岁的男性因一周来的不适到急诊就诊。他最近因新发背痛住院 2 天，出院时给予非阿片类止痛药，但仍因感觉不适而继续就诊。就诊时，他无发热，白细胞增多。体格检查发现左膝关节疼痛，无创伤证据。关节穿刺抽出脓性液体，白细胞升高，符合化脓性关节炎。他开始接受广谱抗生素治疗，并进行了左膝关节灌洗和滑膜切除术。关节液和血培养均生长出
经胸超声心动图未见赘生物；然而，腰椎 MRI 显示 L2-L3 和 L4-L5 骨髓炎。他接受了 3 周的静脉头孢曲松治疗，然后又接受了 3 周的口服左氧氟沙星治疗，总共 6 周的抗生素治疗。
