Koutserimpas Christos, Kotzias Dimitrios, Naoum Symeon, Arkoudis Nikolaos-Achilleas, Bountogiannis Petros
Department of Orthopaedics and Traumatology, "251" Hellenic Air Force General Hospital, Athens, Greece.
Department of Radiology, General University Hospital of Athens "Attikon", Athens, Greece.
J Orthop Case Rep. 2022 Dec;12(12):66-70. doi: 10.13107/jocr.2022.v12.i12.3468.
Septic arthritis usually affects native joints and represents an invasion of the joint space by a wide variety of microorganisms, most commonly bacteria, such as Staphylococci, Streptococci, and Gram-negative rods. An extremely rare case of septic knee arthritis caused by Pantoea agglomerans in a 67-year-old male is presented.
The patient was initially treated with arthroscopic debridement, but due to persistent symptomatology open surgical debridement 3 days after initial surgery was also performed. Cultures yielded P. agglomerans and Streptococcus agalactiae. He was commenced on causative antimicrobial treatment including intravenous linezolid, ciprofloxacin, and clindamycin. He was discharged 10 days later, on oral linezolid and ciprofloxacin for 3 months.
Delayed diagnosis in septic arthritis cases and inadequate control of the infection may lead to insufficient treatment and devastating consequences for the patient. The treatment includes surgical debridement and proper antimicrobial agents. Cultures dictate the proper treatment; hence, microbiological examination is of utmost importance, since it may reveal unusual organisms for which empirical treatment may prove insufficient.
化脓性关节炎通常累及天然关节，是多种微生物侵入关节腔所致，最常见的是细菌，如葡萄球菌、链球菌和革兰氏阴性杆菌。本文报告了一例极为罕见的由成团泛菌引起的67岁男性化脓性膝关节炎病例。
患者最初接受了关节镜清创治疗，但由于症状持续，在初次手术后3天还进行了开放性手术清创。培养结果显示为成团泛菌和无乳链球菌。患者开始接受针对性抗菌治疗，包括静脉注射利奈唑胺、环丙沙星和克林霉素。10天后出院，口服利奈唑胺和环丙沙星3个月。
化脓性关节炎病例的诊断延迟和感染控制不当可能导致治疗不足，并给患者带来严重后果。治疗包括手术清创和使用合适的抗菌药物。培养结果决定了正确的治疗方法；因此，微生物学检查至关重要，因为它可能揭示出经验性治疗可能不足的不常见病原体。
