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人工关节感染合并金黄色葡萄球菌菌血症和三尖瓣感染性心内膜炎:一例新病例报告

Prosthetic Joint Infection Complicated by Staphylococcus aureus Bacteremia and Tricuspid Valve Infective Endocarditis: A Novel Case Report.

作者信息

Jannat Hoore, Ahmad Hamad

机构信息

Internal Medicine, Khyber Medical College, Peshawar, PAK.

Internal Medicine, Westchester Medical Center, Valhalla, USA.

出版信息

Cureus. 2024 Jul 18;16(7):e64821. doi: 10.7759/cureus.64821. eCollection 2024 Jul.

DOI:10.7759/cureus.64821
PMID:39156362
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11330163/
Abstract

Prosthetic joint infection (PJI) is defined as an infection involving the prosthesis and surrounding soft tissue and bone that is a difficult complication to treat and is a common cause of revision total joint arthroplasty (TJA). Bacteremia, sepsis, and infective endocarditis (IE) are rare complications in patients who have undergone TJA. We report a rare case where a patient presented with purulent discharge from the left knee joint post-TJA concerning PJI and was found to have methicillin-sensitive bacteremia, tricuspid valve endocarditis, and septic pulmonary emboli. The patient underwent irrigation, debridement, and a spacer device placement in the affected knee joint for PJI and was medically treated for IE with six weeks of antibiotic therapy. The patient successfully recovered and was discharged to a rehabilitation facility. We conclude that PJI and IE secondary to TJA are very rare, but given the high morbidity and mortality, if diagnosis and treatment are delayed, physicians should always remain vigilant for these complications in the appropriate clinical context.

摘要

人工关节感染(PJI)被定义为涉及假体以及周围软组织和骨骼的感染,这是一种难以治疗的并发症,也是全关节置换翻修术(TJA)的常见原因。菌血症、败血症和感染性心内膜炎(IE)在接受TJA的患者中是罕见的并发症。我们报告了一例罕见病例,一名患者在TJA后左膝关节出现脓性分泌物,怀疑患有PJI,结果发现患有对甲氧西林敏感的菌血症、三尖瓣心内膜炎和脓毒性肺栓塞。该患者因PJI在患侧膝关节接受了冲洗、清创和间隔器置入,并接受了为期六周的抗生素治疗以治疗IE。患者成功康复并出院前往康复机构。我们得出结论,TJA继发的PJI和IE非常罕见,但鉴于其高发病率和死亡率,如果诊断和治疗延迟,医生在适当的临床背景下应始终对这些并发症保持警惕。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f3c/11330163/e14d3979fe20/cureus-0016-00000064821-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f3c/11330163/dbc46f2f5650/cureus-0016-00000064821-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f3c/11330163/4debb8b7cb70/cureus-0016-00000064821-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f3c/11330163/e14d3979fe20/cureus-0016-00000064821-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f3c/11330163/dbc46f2f5650/cureus-0016-00000064821-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f3c/11330163/4debb8b7cb70/cureus-0016-00000064821-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f3c/11330163/e14d3979fe20/cureus-0016-00000064821-i03.jpg

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