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卡他莫拉菌性败血症性关节炎揭示了一名儿科患者未被诊断出的系统性红斑狼疮。

Moraxella catarrhalis Septic Arthritis Unveils Undiagnosed Systemic Lupus Erythematous in a Pediatric Patient.

作者信息

Rogers Nathaniel G

机构信息

Department of Internal Medicine and Pediatrics, The University of Tennessee Health Science Center, Memphis, USA.

出版信息

Cureus. 2023 Dec 21;15(12):e50909. doi: 10.7759/cureus.50909. eCollection 2023 Dec.

Abstract

Septic arthritis is uncommon in pediatric patients, who are less likely to have major risk factors such as underlying joint disease or prosthetic joints. It only rarely affects the elbow and is usually caused by Gram-positive cocci, with being the most common bacterial organism. We present the case of a 15-year-old previously healthy female who experienced new-onset monoarticular nontraumatic elbow pain and was found to have a synovial effusion growing from . The atypical clinical presentation, coupled with the growth of an unusual organism, raised concern for an underlying immunocompromising or inflammatory joint disorder. Further laboratory workup ultimately revealed a diagnosis of systemic lupus erythematosus (SLE), which more commonly presents with arthralgias that are polyarticular, symmetric, and migratory. This case report should encourage clinicians to maintain a high degree of suspicion for underlying joint disease when septic arthritis presents atypically.

摘要

化脓性关节炎在儿科患者中并不常见,这类患者出现诸如潜在关节疾病或人工关节等主要危险因素的可能性较小。它很少累及肘部,通常由革兰氏阳性球菌引起,其中 是最常见的细菌种类。我们报告一例15岁既往健康的女性病例,该患者出现新发的单关节非创伤性肘部疼痛,且发现滑膜积液培养自 。非典型的临床表现,再加上培养出不寻常的微生物,引发了对潜在免疫功能低下或炎性关节疾病的担忧。进一步的实验室检查最终确诊为系统性红斑狼疮(SLE),该病更常见的表现是多关节、对称性和游走性的关节痛。本病例报告应促使临床医生在化脓性关节炎表现不典型时,对潜在关节疾病保持高度怀疑。

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