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非人工关节的肩部血源性化脓性关节炎病因:一例病例报告及文献综述

Hematogenous septic arthritis of a non-prosthetic shoulder caused by : A case report and review of the literature.

作者信息

Vanwielendaele Maxime, Chérif Mohammad Yassine, Hing Mony, Colman Michiel, Ferchichi Mohamed Amine, Raoul Joseph Fritz, Maillart Eveline, Badot Valérie, Clevenbergh Philippe

机构信息

Internal Medicine Department, University Hospital Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium.

Rheumatic Diseases Clinic, University Hospital Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium.

出版信息

IDCases. 2023 Feb 13;31:e01717. doi: 10.1016/j.idcr.2023.e01717. eCollection 2023.

Abstract

, oral inhabitants of dogs and cats is a cause of zoonotic infections. It is transmitted to humans by bites, scratches, licks, or close exposure to these animals. Infections due to have a wide range of severity and can sometimes be fatal. We report the case of an 89-years-old man who suffered from a sudden swollen native right shoulder. The blood test revealed an inflammatory syndrome and cytologic evaluation of joint aspiration showed an elevated nucleated cells count suspicious of infection. A Gram-negative bacillus grew after 48 h in the arthrocentesis and was identified as After 4 days, blood culture also grew leading to the diagnosis of hematogenous septic arthritis of a non-prosthetic right shoulder. Antimicrobial therapy was empirically started with cefuroxime then switched to doxycycline for seven weeks with good clinical outcomes. It is important to inquire about patients' environment including their proximity to animals as it can lead to zoonotic infections that can be of high severity. Moreover, hygiene rules must be applied when dog scratches or lick wounds occurred to avoid the spread of zoonotic germs. Prophylactic antibiotic therapy should be given for animal bites.

摘要

狗和猫口腔中的(某种病菌,原文未明确写出)是一种人畜共患感染的病因。它通过咬伤、抓伤、舔舐或与这些动物密切接触传播给人类。由(该病菌)引起的感染严重程度范围广泛,有时可能致命。我们报告一例89岁男性病例,该患者右肩部突然肿胀。血液检查显示有炎症综合征,关节穿刺液的细胞学评估显示有核细胞计数升高,怀疑有感染。关节穿刺抽出液在48小时后培养出一种革兰氏阴性杆菌,被鉴定为(某种病菌,原文未明确写出)。4天后,血培养也培养出(该病菌),从而诊断为非人工关节的右肩部血源性化脓性关节炎。经验性地开始使用头孢呋辛进行抗菌治疗,然后改用强力霉素治疗7周,临床效果良好。询问患者的生活环境,包括他们与动物的接触情况很重要,因为这可能导致严重的人畜共患感染。此外,当发生狗抓伤或舔舐伤口时,必须遵守卫生规则,以避免人畜共患病菌的传播。对于动物咬伤应给予预防性抗生素治疗。

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