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双侧隐球菌性鹰嘴滑囊炎一例。

A Case of Bilateral Cryptococcal Olecranon Bursitis.

作者信息

Bianco Saverio Francesco, Paris Andrea Noah, Galdes Nicole, Bianco Bernice

机构信息

Orthopaedics and Trauma, Mater Dei Hospital, Msida, MLT.

Surgery, Mater Dei Hospital, Msida, MLT.

出版信息

Cureus. 2024 Jul 13;16(7):e64449. doi: 10.7759/cureus.64449. eCollection 2024 Jul.

DOI:10.7759/cureus.64449
PMID:39135812
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11317912/
Abstract

Non-septic olecranon bursitis (NSOB) is the inflammation of the olecranon bursa, which is usually self-limiting with aseptic clinical manifestations. NSOB can be idiopathic or secondary to repetitive trauma or rheumatological conditions. Septic olecranon bursitis (SOB) is usually caused by bacterial skin colonisers, such as staphylococci and streptococci, and patients tend to present with systemic symptoms requiring medical and/or surgical interventions. Herein we present a case of disseminated cryptococcal infection stemming from bilateral septic olecranon bursitis in a previously healthy immunocompetent 24-year-old female. Fluid cultures were positive for . Patient underwent bilateral olecranon bursectomy, washouts and debridement. Moreover, the patient was started on long-term intravenous amphotericin B and later switched to oral flucytosine and fluconazole with good effect. Patient had good clinical outcomes at one-year follow-up.  SOB secondary to unusual pathogens, such as , is a rare occurrence, and tends to affect immunocompromised individuals. The clinical course of such infections has shown to be subtle and insidious, which in turn hinders the diagnosis and leads to inappropriate treatment administration. Early follow-up and consideration of these organisms, together with appropriate discussion with microbiologists and/or infectious disease teams is crucial to reduce long-term morbidity and mortality.

摘要

非感染性鹰嘴滑囊炎(NSOB)是鹰嘴滑囊的炎症,通常具有无菌性临床表现且为自限性。NSOB 可为特发性,或继发于重复性创伤或风湿性疾病。感染性鹰嘴滑囊炎(SOB)通常由皮肤定植菌如葡萄球菌和链球菌引起,患者往往会出现需要药物和/或手术干预的全身症状。在此,我们报告一例 24 岁既往健康的免疫功能正常女性因双侧感染性鹰嘴滑囊炎引发播散性隐球菌感染的病例。液体培养结果为……阳性。患者接受了双侧鹰嘴滑囊切除术、冲洗和清创术。此外,患者开始接受长期静脉注射两性霉素 B 治疗,之后改为口服氟胞嘧啶和氟康唑,效果良好。患者在一年随访时临床预后良好。由不常见病原体如……引起的 SOB 较为罕见,且往往影响免疫功能低下个体。此类感染的临床病程已显示出隐匿性,这反过来会妨碍诊断并导致治疗不当。早期随访并考虑这些病原体,同时与微生物学家和/或感染病团队进行适当讨论,对于降低长期发病率和死亡率至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50cd/11317912/e2838cf6fd50/cureus-0016-00000064449-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50cd/11317912/0dc3fbaca830/cureus-0016-00000064449-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50cd/11317912/2add1aebb620/cureus-0016-00000064449-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50cd/11317912/148b68a19e73/cureus-0016-00000064449-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50cd/11317912/e2838cf6fd50/cureus-0016-00000064449-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50cd/11317912/0dc3fbaca830/cureus-0016-00000064449-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50cd/11317912/2add1aebb620/cureus-0016-00000064449-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50cd/11317912/148b68a19e73/cureus-0016-00000064449-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50cd/11317912/e2838cf6fd50/cureus-0016-00000064449-i04.jpg

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本文引用的文献

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Cryptococcus neoformans, a global threat to human health.新型隐球菌,人类健康的全球性威胁。
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