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因抗生素诱导的中性粒细胞减少症导致的罕见缓症链球菌机会性感染致人工关节感染

A Rare Occurrence of Opportunistic Infection by Streptococcus mitis Due to Antibiotic-Induced Neutropenia in Prosthetic Joint Infection.

作者信息

Tan Eng Kee, Ahmad Hanif Khairil Anwar, Jebasingam Issace Samuel John, Che-Hamzah Fahrudin

机构信息

Orthopaedics and Traumatology, Ministry of Health Malaysia, Selangor, MYS.

Orthopaedics and Traumatology, Hospital Pengajar Universiti Putra Malaysia, Serdang, MYS.

出版信息

Cureus. 2023 Feb 28;15(2):e35583. doi: 10.7759/cureus.35583. eCollection 2023 Feb.

Abstract

Prosthetic joint infection (PJI) is a devastating complication in arthroplasty surgery. Although the prevalence is less than 2%, its functional and financial implications are significant. Part of its treatment involves the usage of prolonged and high-dose systemic antibiotics. Ironically, this predisposes the patient to unwanted adverse effects caused by the drugs. We report a case of cefazolin-induced neutropenia that led to () bacteraemia in a patient with PJI. There have been no previous reports on cefazolin-induced neutropenic bacteraemia complicating the treatment of PJI. This case report aims to create awareness among the attending physicians on the possibility of cefazolin-induced neutropenia, which led to bacteraemia from an opportunistic microorganism. The reversal was as simple as cessation of the antibiotic itself. However, if not recognized, it could be fatal.

摘要

人工关节感染(PJI)是关节置换手术中一种极具破坏性的并发症。尽管其发生率低于2%,但其对功能和经济的影响却很显著。其治疗部分包括长期使用高剂量的全身性抗生素。具有讽刺意味的是,这使患者易遭受药物带来的不良副作用。我们报告一例头孢唑林诱导的中性粒细胞减少症病例,该病例导致一名患有PJI的患者发生()菌血症。此前尚无关于头孢唑林诱导的中性粒细胞减少性菌血症使PJI治疗复杂化的报道。本病例报告旨在使主治医生认识到头孢唑林诱导中性粒细胞减少症的可能性,这种情况导致了由机会性微生物引起的菌血症。解决方法很简单,即停用抗生素本身。然而,如果未被识别,可能会致命。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e20b/10062401/b27d76774fdd/cureus-0015-00000035583-i01.jpg

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