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嗜肺军团菌致关节炎 1 例并文献复习

Case report of arthritis caused by Legionella anisa and review of the literature.

机构信息

Department of Rheumatology, Hospices Civils de Lyon, Service de Rhumatologie Sud, Centre Hospitalier Lyon Sud, 165, Chemin du Grand Revoyet, 69310, Pierre Bénite, France.

出版信息

BMC Infect Dis. 2022 Jul 20;22(1):633. doi: 10.1186/s12879-022-07475-3.

Abstract

BACKGROUND

Legionella spp. is recognized as a common cause of community acquired pneumonia, with Legionella pneumophila serogroup 1 being the most prevalent. At least 70 species are described so far but few are identified in pathogenic conditions. Data on extrapulmonary infections are scarce.

CASE PRESENTATION

A 73-yar-old male with chronic lymphoid leukemia was hospitalized for an insidious wrist arthritis. Ultrasound of the wrist showed a carpal and radiocarpal fluid effusion with positive Doppler signal. While routine bacterial cultures remained sterile, 16S rRNA PCR identified Legionella anisa. Ciprofloxacin 500 mg twice a day for a period of six weeks improved arthritis with full recovery at the end of the treatment.

CONCLUSION

Legionella non pneumophila are a rare cause of septic arthritis especially found in immunosuppressed patients and identification of species could help clinician to adapt antibiotherapy.

摘要

背景

军团菌属被认为是社区获得性肺炎的常见病因,其中嗜肺军团菌血清群 1 最为常见。迄今已描述了至少 70 种,但在致病条件下很少能鉴定出。关于肺外感染的数据很少。

病例介绍

一名 73 岁男性,患有慢性淋巴细胞白血病,因隐匿性腕关节炎住院。腕关节超声显示腕骨和桡腕关节积液,伴有阳性多普勒信号。虽然常规细菌培养仍为无菌,但 16S rRNA PCR 鉴定出嗜肺军团菌。环丙沙星 500mg,每日两次,持续六周,关节炎得到改善,治疗结束时完全恢复。

结论

嗜肺军团菌以外的其他种属是脓毒性关节炎的罕见病因,特别是在免疫抑制患者中发现,鉴定物种有助于临床医生调整抗生素治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51e8/9297545/eca18df65f58/12879_2022_7475_Fig1_HTML.jpg

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