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一名有20年慢性淋巴细胞白血病病史的免疫功能低下患者并发化脓性关节炎和前臂坏死性筋膜炎的外科治疗:病例报告

Surgical Management of Concurrent Septic Arthritis and Forearm Necrotizing Fasciitis in an Immunocompromised Patient With a 20-Year History of Chronic Lymphocytic Leukemia: A Case Report.

作者信息

Ozturk Burak, Celayir Arın, Cibikci Ali Osman G, Davulcu Cumhur Deniz, Kaynak Gokhan

机构信息

Orthopaedics and Traumatology, Istanbul University Cerrahpasa - Cerrahpasa Faculty of Medicine, Istanbul, TUR.

出版信息

Cureus. 2024 Nov 29;16(11):e74739. doi: 10.7759/cureus.74739. eCollection 2024 Nov.

Abstract

Shoulder septic arthritis is a severe infection of the shoulder joint, commonly caused by bacteria such as . It leads to inflammation, severe pain, swelling, and reduced mobility in the affected shoulder. The condition is typically diagnosed through clinical evaluation, blood tests, imaging studies, and joint aspiration. Prompt treatment, usually involving antibiotics and sometimes surgical intervention, is crucial to prevent joint destruction and other serious complications. Necrotizing fasciitis of the upper extremity is a rapidly progressing, life-threatening bacterial infection that affects the fascia - the connective tissue surrounding muscles, nerves, and blood vessels. This condition is characterized by severe pain, swelling, erythema, and tissue necrosis. Commonly caused by bacteria such as , it requires immediate medical attention. Diagnosis is often based on clinical evaluation, imaging, and laboratory tests. We discuss the surgical treatment of a patient referred to our clinic with a preliminary diagnosis of septic arthritis and a history of chronic lymphocytic leukemia that had been untreated and not followed up. During the examination, we also considered the possibility of gas gangrene in the arm and forearm.

摘要

肩部化脓性关节炎是肩关节的一种严重感染,通常由诸如……等细菌引起。它会导致炎症、剧痛、肿胀以及患侧肩部活动能力下降。该病症通常通过临床评估、血液检查、影像学检查和关节穿刺来诊断。及时治疗,通常包括使用抗生素,有时还需要手术干预,对于预防关节破坏和其他严重并发症至关重要。上肢坏死性筋膜炎是一种进展迅速、危及生命的细菌感染,会影响筋膜——围绕肌肉、神经和血管的结缔组织。这种病症的特征是剧痛、肿胀、红斑和组织坏死。通常由诸如……等细菌引起,需要立即就医。诊断通常基于临床评估、影像学检查和实验室检查。我们讨论了一名转诊至我们诊所的患者的手术治疗情况,该患者初步诊断为化脓性关节炎,并有未经治疗和未随访的慢性淋巴细胞白血病病史。在检查过程中,我们还考虑了手臂和前臂发生气性坏疽的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef4f/11682684/889c8f93b4a7/cureus-0016-00000074739-i01.jpg

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