Division of Orthopaedic Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
J Med Case Rep. 2023 Jun 10;17(1):249. doi: 10.1186/s13256-023-03961-7.
Infective arthritis is an orthopaedic surgical emergency. Staphylococcus aureus remains the commonest causative bacteria across all age groups. Prevotella spp. as a cause of infective arthritis is extremely rare.
We present our case of a 30-year-old African male patient who presented with mild signs of infective arthritis of the left hip. His risk factors were his background retroviral disease, intravenous drug abuse, and a previous episode of left hip arthrotomy which healed expectantly with intervention. The current presentation was treated with arthrotomy of the hip, fluid lavage, and skeletal traction based on our clinical findings and the rarity of the presentation was seen to be mobilising non-weight bearing with crutches, and pain-free on the left hip.
A high index of suspicion for Prevotella Septic Arthritis (PSA) should be exercised when treating infective arthritis patients with background joint arthropathies, and intravenous drug abuse, especially in individuals with significant immunosuppression and/or recent tooth extraction. Fortunately, although rare an entity, good outcomes can be expected with early diagnosis and classic treatment principles of joint decompression and lavage as well as guided antibiotic therapy.
感染性关节炎是一种骨科急症。金黄色葡萄球菌仍然是所有年龄段最常见的致病细菌。普雷沃氏菌属作为感染性关节炎的病因极其罕见。
我们报告了一位 30 岁的非洲男性患者，他表现出轻度左髋关节感染性关节炎的症状。他的危险因素是背景逆转录病毒疾病、静脉药物滥用以及先前的左髋关节切开术，该切开术经干预后预期愈合。根据我们的临床发现，对该患者进行了髋关节切开术、液体冲洗和骨骼牵引治疗，其临床表现的罕见性表现为非负重活动和左髋关节无痛。
对于有背景关节病和静脉药物滥用的感染性关节炎患者，尤其是有明显免疫抑制和/或近期拔牙的患者，应高度怀疑普雷沃氏菌属感染性关节炎（PSA）。幸运的是，尽管罕见，但早期诊断和经典的关节减压和冲洗以及指导抗生素治疗的治疗原则可以预期获得良好的结果。
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