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免疫功能正常的成年患者因利奈唑胺导致并接受长期治疗的罕见髋关节化脓性关节炎:病例报告及简短文献综述

Uncommon Septic Arthritis of the Hip Joint in an Immunocompetent Adult Patient Due to and Managed with Long-Term Treatment with Linezolid: A Case Report and Short Literature Review.

作者信息

Cismasiu Razvan Silviu, Birlutiu Rares-Mircea, Preoțescu Liliana Lucia

机构信息

Clinical Hospital of Orthopedics, Traumatology, and Osteoarticular TB Bucharest, B-dul Ferdinand 35-37, Sector 2, 021382 Bucharest, Romania.

Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania.

出版信息

Pharmaceuticals (Basel). 2023 Dec 18;16(12):1743. doi: 10.3390/ph16121743.

Abstract

The and genera are diverse soil-related bacterial pathogens. In this case report, we describe, to our knowledge, the first report of septic arthritis in a native hip joint in an immunocompetent adult patient caused by and . We describe the case of a 39-year-old Caucasian male patient who sought medical advice for chronic pain on the mobilization of the right hip, decreased range of motion, and physical asthenia. The patient underwent a surgical intervention (core decompression) for a right osteonecrosis of the femoral head, with a slightly favorable postoperative evolution after surgery for one month. Surgical treatment was planned on the basis of clinical and paraclinical investigations and the joint damage. The hip was explored using an anterior approach under spinal anesthesia and standard antibiotic prophylaxis. After resection of the femoral head, meticulous debridement of all inflammatory tissues was performed, and a preformed temporary spacer was inserted into the femoral canal. Bacteriological laboratory studies identified and via matrix-assisted laser desorption-ionization time-of-flight mass spectrometry analysis. The patient initially received nine days of empirical therapy with intravenous antibiotics (linezolid and meropenem). After the bacterial strains were identified, the patient received organism-specific antibiotic therapy with the same antibiotics and dose for eight days until discharge. After discharge, the patient was referred to another hospital, where he continued treatment with linezolid for seven weeks and, after that, four weeks of oral therapy with cotrimoxazole and rifampicin. During this period, no severe or potentially life-threatening adverse events were recorded during long-term treatment with linezolid or with the two oral antibiotics. In conclusion, our findings suggest that long-term treatment with linezolid may be a viable option for the management of bone and joint infections caused by and .

摘要

[具体菌属名称1]和[具体菌属名称2]是与土壤相关的多种细菌病原体。在本病例报告中,据我们所知,我们描述了首例由[具体菌属名称1]和[具体菌属名称2]引起的免疫功能正常成年患者原生髋关节化脓性关节炎。我们描述了一名39岁的白种男性患者的病例,该患者因右髋关节活动时慢性疼痛、活动范围减小和身体乏力而寻求医疗建议。该患者因右侧股骨头缺血性坏死接受了手术干预(髓芯减压),术后一个月病情略有好转。根据临床和辅助检查以及关节损伤情况制定了手术治疗方案。在脊髓麻醉和标准抗生素预防措施下,采用前路入路对髋关节进行探查。切除股骨头后,对所有炎性组织进行了细致清创,并在股骨髓腔内插入了预制的临时间隔物。细菌学实验室研究通过基质辅助激光解吸电离飞行时间质谱分析鉴定出了[具体菌属名称1]和[具体菌属名称2]。患者最初接受了九天的经验性静脉抗生素治疗(利奈唑胺和美罗培南)。细菌菌株鉴定后,患者接受了针对病原体的抗生素治疗,使用相同的抗生素和剂量,持续八天直至出院。出院后,患者被转诊至另一家医院,在那里他继续使用利奈唑胺治疗七周,之后使用复方新诺明和利福平进行四周的口服治疗。在此期间,在长期使用利奈唑胺或两种口服抗生素治疗过程中,未记录到严重或潜在危及生命的不良事件。总之,我们的研究结果表明,长期使用利奈唑胺可能是治疗由[具体菌属名称1]和[具体菌属名称2]引起的骨和关节感染的可行选择。

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