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产后感染性骨关节炎:一项病例系列研究。

Postpartum Septic Osteoarthritis: A case series study.

作者信息

Baccouche Khadija, Khadar Ahmed, Guesmi Ayoub, Khalifa Dhouha, Fakhfekh Rym, Daldoul Cyrine, Elamri Nejla, Bouajina Elyes

机构信息

University of Sousse, Faculty of Medicine of Ibn ElJazzar Sousse, 4002, Farhat Hached university Hôpital, Service of rheumatology, 4031, Sousse, Tunisia.

University of Sousse, Faculty of Medicine of Ibn ElJazzar Sousse, 4002, Farhat Hached university Hospital, service of medical Imaging, 4031, sousse, Tunisia.

出版信息

Tunis Med. 2024 Dec 5;102(12):1067-1071. doi: 10.62438/tunismed.v102i12.5403.

Abstract

Introduction-Aim: Postpartum septic osteoarthritis is a rare but serious condition often misdiagnosed due to overlap with common postpartum symptoms like pelvic pain and joint stiffness. This case series aims to describe the clinical, bacteriological, and radiological characteristics of postpartum septic osteoarthritis, as well as the treatment approaches and patient outcomes. Methods: A retrospective case series was conducted at Farhat Hached University Hospital, from 2006 to 2022, involving patients with confirmed postpartum septic osteoarthritis. Clinical data, laboratory findings, imaging results, treatments, and outcomes were analyzed Results: The mean age of the seven patients was 31.4 years. All patients presented with joint pain, with fever and functional impairment where each was observed in 85.7% of cases. The average diagnostic delay was 17 days. MRI findings revealed bone marrow edema in all patients, Abscesses in 28.5% of cases, periarticular soft tissue edema, and intra-articular effusions in 71.4% of cases. The pubic symphysis was the most commonly affected site (57.1%), followed by the sacroiliac joints (28.6%). Only one pathogen, Streptococcus pyogenes, was isolated. Nearly all patients received dual antibiotic therapy for an average duration of 4 to 6 weeks. Satisfactory clinical progress without sequelae was noted and maintained after an average follow-up of 5 to 6 months. .Conclusion: Our results revealed that postpartum septic osteoarthritis requires prompt diagnosis and early treatment to prevent severe complications. MRI plays a critical role in early detection, while timely antibiotic therapy leads to favorable long-term outcomes.

摘要

引言-目的:产后感染性骨关节炎是一种罕见但严重的疾病,常因与骨盆疼痛和关节僵硬等常见产后症状重叠而被误诊。本病例系列旨在描述产后感染性骨关节炎的临床、细菌学和放射学特征,以及治疗方法和患者预后。方法:对2006年至2022年在法哈特·哈谢德大学医院确诊为产后感染性骨关节炎的患者进行回顾性病例系列研究。分析临床数据、实验室检查结果、影像学结果、治疗方法和预后。结果:7例患者的平均年龄为31.4岁。所有患者均有关节疼痛,85.7%的病例出现发热和功能障碍。平均诊断延迟为17天。MRI检查结果显示,所有患者均有骨髓水肿,28.5%的病例有脓肿,71.4%的病例有关节周围软组织水肿和关节内积液。耻骨联合是最常受累部位(57.1%),其次是骶髂关节(28.6%)。仅分离出一种病原体,即化脓性链球菌。几乎所有患者均接受了平均4至6周的联合抗生素治疗。平均随访5至6个月后,临床进展令人满意,无后遗症。结论:我们的结果表明,产后感染性骨关节炎需要及时诊断和早期治疗以预防严重并发症。MRI在早期检测中起关键作用,而及时的抗生素治疗可带来良好的长期预后。

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