Shanti Ibrahim, Samardali Malik, Gebremedhen Adamsegd I
Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Cureus. 2024 Nov 22;16(11):e74264. doi: 10.7759/cureus.74264. eCollection 2024 Nov.
Prosthetic joint infection (PJI), caused by Streptococcus bovis group (SBG), is uncommon and related to colorectal cancer. We present here a case of an 84-year-old male who had a past medical history of chronic obstructive pulmonary disease (COPD), congestive heart failure, pulmonary arterial hypertension, iron deficiency anemia, chronic kidney disease, diabetes mellitus, gout, hypertension, bilateral knee replacement with left knee pain and swelling. We initially suspected gout and treated him with prednisolone, but it did not relieve him. Joint aspiration revealed high WBC, predominantly neutrophils, and polymerase chain reaction (PCR)-identified Streptococcus lutetiensis. The patient underwent knee incision, drainage, poly exchange, and wound vacuum-assisted closure (VAC) placement. Sensitivity testing led us to treat him with ceftriaxone. Echocardiography revealed no endocarditis. A colonoscopy revealed multiple non-bleeding polyps and adenomas. After discharge, our patient completed six weeks of ceftriaxone via a peripherally inserted central catheter (PICC) line. At follow-up, our patient reported no complaints of fever and knee swelling.
由牛链球菌群（SBG）引起的人工关节感染（PJI）并不常见，且与结直肠癌有关。我们在此报告一例84岁男性病例，他既往有慢性阻塞性肺疾病（COPD）、充血性心力衰竭、肺动脉高压、缺铁性贫血、慢性肾脏病、糖尿病、痛风、高血压病史，双侧膝关节置换术后，左膝疼痛肿胀。我们最初怀疑是痛风，用泼尼松龙治疗，但症状未缓解。关节穿刺显示白细胞计数高，以中性粒细胞为主，聚合酶链反应（PCR）鉴定为路邓葡萄球菌。患者接受了膝关节切开、引流、假体置换及伤口负压封闭引流（VAC）置管。药敏试验结果使我们用头孢曲松对其进行治疗。超声心动图显示无感染性心内膜炎。结肠镜检查发现多个无出血性息肉和腺瘤。出院后，我们的患者通过外周静脉穿刺中心静脉导管（PICC）完成了为期六周的头孢曲松治疗。随访时，患者报告无发热和膝关节肿胀的主诉。
