Adams Jennifer P, Habenicht Daniel, Ramsey Duncan
University of Texas Rio Grande Valley School of Medicine, Harlingen, TX, USA.
Department of Orthopedic Surgery, University of Texas Rio Grande Valley School of Medicine, Harlingen, TX, USA.
Ann Med Surg (Lond). 2022 Aug 1;81:104292. doi: 10.1016/j.amsu.2022.104292. eCollection 2022 Sep.
Periprosthetic joint infection (PJI) is a major complication after total knee arthroscopy. Enterobacter is a rare cause of PJI.
We present a 65 year old Caucasian man who presented with acute right knee PJI with Carbapenem-resistant Enterobacteriaceae (CRE) two months after undergoing right knee intra-articular mass removal with endoprosthetic reconstruction. The periprosthetic joint infection (PJI) was treated with revision with 1-stage static spacer and IV meropenem.
CRE is an uncommon cause of PJI, but when it does occur, it commonly infects patients who are immunosuppressed or have specific risk factors. For an immunocompetent patient with CRE PJI, we suggest further workup for other systemic disease.
This case demonstrates the importance of early diagnosis and treatment of CRE joint infections and the need for a multidisciplinary approach that includes aggressive surgical intervention and tailored antimicrobial therapy.
人工关节周围感染（PJI）是全膝关节镜检查后的主要并发症。肠杆菌是PJI的罕见病因。
我们报告一名65岁的白种男性，在接受右膝关节内肿块切除并进行假体重建两个月后，出现了耐碳青霉烯类肠杆菌科细菌（CRE）引起的急性右膝PJI。人工关节周围感染（PJI）采用一期静态间隔物翻修术和静脉注射美罗培南进行治疗。
CRE是PJI的罕见病因，但一旦发生，通常感染免疫抑制或有特定危险因素的患者。对于免疫功能正常的CRE PJI患者，我们建议进一步检查是否存在其他全身性疾病。
本病例证明了早期诊断和治疗CRE关节感染的重要性，以及采用多学科方法的必要性，该方法包括积极的手术干预和定制的抗菌治疗。
