Suppr超能文献

翻修肩关节置换术中新型隐球菌假体周围关节感染:一例报告

Cryptococcus neoformans Periprosthetic Joint Infection in the Setting of Revision Shoulder Arthroplasty: A Case Report.

作者信息

Gabriel Speros, Boin Michael A

机构信息

Orthopedic Surgery, HCA Research Medical Center, Kansas City, USA.

Orthopedic Surgery, North Kansas City Hospital, Kansas City, USA.

出版信息

Cureus. 2024 Oct 11;16(10):e71253. doi: 10.7759/cureus.71253. eCollection 2024 Oct.

Abstract

An 83-year-old male, status one year post-primary right reverse shoulder arthroplasty, presented with clinical and radiographic signs of shoulder instability. The patient subsequently underwent revision reverse shoulder arthroplasty with postoperative cultures growing in all five tissue samples. He was placed on temporary fluconazole since he demanded to leave the hospital during a holiday weekend with plans to get readmitted later. IV amphotericin B was used as induction treatment for two weeks followed by PO voriconazole, which was taken by the patient until eight months postoperatively. He was followed up in the orthopedic clinic status post revision procedure at one and two months and was found to be progressing well. The patient presented to the emergency department eight months after the revision procedure for an unrelated concern that was inconsequential. There were no signs of infection as vital signs and laboratory markers were normal. At 18 months postoperatively, he presented to an outside facility with a left distal femur periprosthetic fracture around a total knee implant, for which open reduction and internal fixation (ORIF) was performed. During this hospital stay, an orthopedic team, known to the authors, evaluated the patient. The right shoulder was stable and without pain, with vitals signs and laboratory markers showing no signs of infection. The patient reported that he continued to be employed as a maintenance worker at a motel. He was discharged soon and is living with current revision shoulder arthroplasty implants.

摘要

一名83岁男性,在初次右肩关节反置置换术后一年,出现肩关节不稳定的临床和影像学表现。该患者随后接受了翻修肩关节反置置换术,术后所有五个组织样本的培养物均生长出细菌。由于他在节假日周末要求出院并计划稍后再次入院,因此给他临时使用了氟康唑。静脉注射两性霉素B作为诱导治疗两周,随后口服伏立康唑,患者一直服用至术后八个月。在翻修手术后的1个月和2个月,他在骨科门诊接受随访,发现恢复良好。翻修手术后8个月,患者因一个无关紧要的问题前往急诊科。生命体征和实验室指标正常,没有感染迹象。术后18个月,他因全膝关节置换周围的左股骨远端假体周围骨折前往外部医疗机构就诊,接受了切开复位内固定术(ORIF)。在此次住院期间,作者熟知的一个骨科团队对患者进行了评估。右肩稳定且无疼痛,生命体征和实验室指标均无感染迹象。患者报告称他仍在一家汽车旅馆担任维修工人。他很快出院,目前使用翻修后的肩关节置换植入物生活。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f213/11550565/c58276b31ca4/cureus-0016-00000071253-i01.jpg

相似文献

1
Cryptococcus neoformans Periprosthetic Joint Infection in the Setting of Revision Shoulder Arthroplasty: A Case Report.
Cureus. 2024 Oct 11;16(10):e71253. doi: 10.7759/cureus.71253. eCollection 2024 Oct.
3
Success of staged revision reverse total shoulder arthroplasty in eradication of periprosthetic joint infection.
J Shoulder Elbow Surg. 2023 Mar;32(3):625-635. doi: 10.1016/j.jse.2022.09.006. Epub 2022 Oct 12.
6
What Are Risk Factors for Intraoperative Humerus Fractures During Revision Reverse Shoulder Arthroplasty and Do They Influence Outcomes?
Clin Orthop Relat Res. 2015 Oct;473(10):3228-34. doi: 10.1007/s11999-015-4448-x. Epub 2015 Jul 11.
7
Hemi-reverse revision arthroplasty in the setting of severe glenoid bone loss.
J Shoulder Elbow Surg. 2022 Sep;31(9):1859-1873. doi: 10.1016/j.jse.2022.02.018. Epub 2022 Mar 23.
8
Operative and nonoperative treatment of periprosthetic humerus fractures after shoulder arthroplasty: a systematic review and meta-analysis.
J Shoulder Elbow Surg. 2024 Nov;33(11):e629-e636. doi: 10.1016/j.jse.2024.04.009. Epub 2024 Jun 3.
9
Proximal Humerus Tumors: Higher-than-Expected Risk of Revision With Constrained Reverse Shoulder Arthroplasty.
Clin Orthop Relat Res. 2020 Nov;478(11):2585-2595. doi: 10.1097/CORR.0000000000001245.

本文引用的文献

1
Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM.
Lancet Infect Dis. 2024 Aug;24(8):e495-e512. doi: 10.1016/S1473-3099(23)00731-4. Epub 2024 Feb 9.
2
Cryptococcus neoformans, a global threat to human health.
Infect Dis Poverty. 2023 Mar 17;12(1):20. doi: 10.1186/s40249-023-01073-4.
3
Cryptococcus magnus Periprosthetic Shoulder Infection: A Case Report.
JBJS Case Connect. 2020 Dec 10;10(4):e20.00507. doi: 10.2106/JBJS.CC.20.00507.
4
Decreasing fluconazole susceptibility of clinical South African Cryptococcus neoformans isolates over a decade.
PLoS Negl Trop Dis. 2020 Mar 31;14(3):e0008137. doi: 10.1371/journal.pntd.0008137. eCollection 2020 Mar.
5
Periprosthetic Joint Infection of Shoulder Arthroplasties: Diagnostic and Treatment Options.
Biomed Res Int. 2017;2017:4582756. doi: 10.1155/2017/4582756. Epub 2017 Dec 20.
6
Complications and revision of reverse total shoulder arthroplasty.
Orthop Traumatol Surg Res. 2016 Feb;102(1 Suppl):S33-43. doi: 10.1016/j.otsr.2015.06.031. Epub 2016 Feb 12.
7
Cryptococcus: from environmental saprophyte to global pathogen.
Nat Rev Microbiol. 2016 Feb;14(2):106-17. doi: 10.1038/nrmicro.2015.6. Epub 2015 Dec 21.
8
Increased Antifungal Drug Resistance in Clinical Isolates of Cryptococcus neoformans in Uganda.
Antimicrob Agents Chemother. 2015 Dec;59(12):7197-204. doi: 10.1128/AAC.01299-15. Epub 2015 Aug 31.
10
Cryptococcus neoformans prosthetic joint infection: case report and review of the literature.
Mycopathologia. 2015 Apr;179(3-4):275-8. doi: 10.1007/s11046-014-9847-0. Epub 2014 Dec 19.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验