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免疫功能正常成人的化脓性关节炎:病例报告及文献复习。

Septic Arthritis in an Immunocompetent Adult: A Case Report and Review of Literature.

机构信息

School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND, USA.

Sanford Health, Fargo, ND, USA.

出版信息

J Investig Med High Impact Case Rep. 2023 Jan-Dec;11:23247096231194842. doi: 10.1177/23247096231194842.

Abstract

Septic arthritis is a medical emergency that requires prompt diagnosis to prevent long-term intra-articular complications. is an anaerobic gram-negative rod which has been infrequently reported to cause septic arthritis. We present a 49-year-old female that presented with spontaneous left knee pain and swelling without history of insult to the knee. She was initially misdiagnosed with patellar tendinitis and gout but later underwent joint aspiration due to worsening symptoms, which demonstrated 60 800/µL nucleated cells with a polymorphonuclear burden consistent with septic arthritis. Arthroscopy with irrigation and drainage was subsequently performed, and the patient was started on empiric antibiotics while awaiting cultures. Cultures grew , and antibiotics were deescalated to ertapenem alone followed by oral metronidazole. species as a source of septic arthritis is rare, and its occurrence in a patient without known insult to the knee is even more uncommon. It is essential that it is recognized to treat appropriately and prevent long-term loss of function in the joint.

摘要

葡萄球菌性关节炎是一种医学急症,需要及时诊断以防止长期的关节内并发症。金黄色葡萄球菌是一种厌氧革兰氏阴性杆菌,很少有报道称其会引起葡萄球菌性关节炎。我们现在介绍一位 49 岁的女性,她出现自发性左膝疼痛和肿胀,无膝关节外伤史。她最初被误诊为髌腱炎和痛风,但后来由于症状恶化进行了关节抽吸,关节液中显示有 60,800/µL 有核细胞,其中多形核细胞负荷与葡萄球菌性关节炎一致。随后进行了关节镜检查、灌洗和引流,在等待培养结果的同时,患者开始使用经验性抗生素治疗。培养结果显示为金黄色葡萄球菌生长,抗生素降级为单独使用厄他培南,然后口服甲硝唑。金黄色葡萄球菌作为葡萄球菌性关节炎的病原体较为罕见,而在无已知膝关节外伤的患者中更为少见。因此,识别它并进行适当治疗以防止关节长期功能丧失至关重要。

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