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新生儿败血症性关节炎、骨髓炎和蜂窝织炎:一例病例报告及诊断与管理的讨论

Septic arthritis, osteomyelitis, and cellulitis in a neonate: A case report and discussion of diagnosis and management.

作者信息

Ahmed Mian Muhammad Hassan, Riaz Sadia, Jamil Manahil, Ashraf Ifra, Khalid Nimra, Adil Maham Leeza

机构信息

Children Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan.

Department of Physiology, Shifa College of Medicine, H-8/4, Islamabad, Pakistan.

出版信息

Int J Surg Case Rep. 2024 Jan;114:109117. doi: 10.1016/j.ijscr.2023.109117. Epub 2023 Dec 6.

Abstract

INTRODUCTION

Septic arthritis, osteomyelitis, and cellulitis are rare but life-threatening conditions in neonates. This case report emphasizes the significance of early diagnosis and intervention in such cases.

PRESENTATION OF CASE

We present a case of a male neonate, who developed septic arthritis, osteomyelitis, and cellulitis following trauma from a fall. The patient presented with fever, swelling, and limited joint movement. Diagnosis was based on clinical evaluation, laboratory investigations, and imaging studies. Treatment involved intravenous antibiotics for three weeks, followed by oral antibiotics for two weeks, resulting in complete recovery.

DISCUSSION

Neonatal septic arthritis and osteomyelitis are challenging to diagnose due to nonspecific symptoms. Early initiation of antibiotics is crucial to prevent long-term complications. Surgical intervention may be required in cases of inadequate antibiotic response or significant joint effusion. This case underscores the importance of prompt recognition and tailored management.

CONCLUSION

Septic arthritis, osteomyelitis, and cellulitis pose serious threats to neonates. Timely diagnosis, appropriate antibiotics, and, if needed, surgical intervention are vital for favorable outcomes. Individualized treatment plans should consider clinical condition and local protocols.

摘要

引言

脓毒性关节炎、骨髓炎和蜂窝织炎在新生儿中较为罕见,但危及生命。本病例报告强调了对此类病例进行早期诊断和干预的重要性。

病例介绍

我们报告一例男性新生儿病例,该患儿在跌倒受伤后发生了脓毒性关节炎、骨髓炎和蜂窝织炎。患儿出现发热、肿胀和关节活动受限。诊断基于临床评估、实验室检查和影像学研究。治疗包括静脉注射抗生素三周,随后口服抗生素两周,最终完全康复。

讨论

由于症状不具特异性,新生儿脓毒性关节炎和骨髓炎的诊断具有挑战性。早期使用抗生素对于预防长期并发症至关重要。在抗生素反应不足或关节积液明显的情况下,可能需要进行手术干预。本病例强调了及时识别和针对性管理的重要性。

结论

脓毒性关节炎、骨髓炎和蜂窝织炎对新生儿构成严重威胁。及时诊断、使用适当的抗生素以及必要时进行手术干预对于取得良好预后至关重要。个体化治疗方案应考虑临床状况和当地治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/654d/10800716/ce375737c3e1/gr1.jpg

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