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人工关节周围感染揭示隐匿性结直肠癌:一例报告

Periprosthetic Joint Infection by Reveals Hidden Colorectal Cancer: A Case Report.

作者信息

Viscopoleanu George, Valeanu Mihai-Sebastian, Capitanu Bogdan-Sorin, Dragosloveanu Serban, Scheau Cristian

机构信息

Department of Orthopaedics, "Foisor" Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania.

Department of Orthopaedics and Traumatology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

出版信息

Life (Basel). 2025 Sep 1;15(9):1385. doi: 10.3390/life15091385.

Abstract

Periprosthetic joint infection (PJI) caused by () is rare but clinically significant due to its established association with colorectal neoplasia. Early recognition and interdisciplinary management are essential to ensure favorable outcomes. We report the case of a 68-year-old woman who presented with a chronic fistula and signs of active infection 20 years after uncemented total hip arthroplasty. Cultures from the wound identified , prompting further evaluation. Imaging and laboratory tests supported a diagnosis of chronic PJI. A two-stage revision was performed, beginning with implant removal, debridement, and placement of a vancomycin/gentamicin-loaded spacer. Given the pathogen's known link to gastrointestinal malignancy, the patient underwent colonoscopy, which revealed a tubulovillous adenoma with carcinoma in situ. Surgical resection was performed with curative intent. Six months later, the patient underwent successful reimplantation. At three-month follow-up, clinical and radiographic assessments showed favorable recovery. This case reinforces the importance of gastrointestinal screening in patients with PJI, as early detection of associated colorectal lesions may impact treatment strategies and prognosis.

摘要

由()引起的人工关节周围感染(PJI)虽然罕见,但由于其与结直肠癌已确定的关联,在临床上具有重要意义。早期识别和多学科管理对于确保良好预后至关重要。我们报告了一例68岁女性病例,该患者在非骨水泥型全髋关节置换术后20年出现慢性瘘管和活动性感染迹象。伤口培养物鉴定出(),促使进行进一步评估。影像学和实验室检查支持慢性PJI的诊断。进行了两阶段翻修手术,首先取出植入物、清创并放置载有万古霉素/庆大霉素的间隔物。鉴于病原体与胃肠道恶性肿瘤的已知关联,患者接受了结肠镜检查,结果显示为原位癌的管状绒毛状腺瘤。进行了根治性手术切除。六个月后,患者成功进行了再植入。在三个月的随访中,临床和影像学评估显示恢复良好。该病例强化了对PJI患者进行胃肠道筛查的重要性,因为早期发现相关的结直肠病变可能会影响治疗策略和预后。

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