Schmidt D R, Heckman J D
J Trauma. 1983 Jun;23(6):478-82. doi: 10.1097/00005373-198306000-00006.
Over a 51/2-year period 30 patients were found with Eikenella corrodens infections of the hand following closed fist injury. Twenty-four had mixed infections; six grew pure cultures of Eikenella. Twenty-one of the 30 patients had positive cultures from an injured metacarpophalangeal joint. A delay in presentation or an inaccurate initial diagnosis appeared to be the most significant factors leading to the complications of osteomyelitis (in five patients) and significant loss of joint function (in eight other patients). Clinicians must have a high index of suspicion when evaluating any hand injury and clenched fist injuries of the hand should be treated by early adequate surgical debridement followed by IV penicillin given until operative cultures confirm or deny contamination with Eikenella corrodens.
在5年半的时间里,发现30例患者在握拳伤后发生了腐蚀艾肯菌手部感染。24例为混合感染;6例培养出纯腐蚀艾肯菌。30例患者中有21例受伤的掌指关节培养结果呈阳性。就诊延迟或初始诊断不准确似乎是导致骨髓炎(5例患者)和关节功能严重丧失(另外8例患者)等并发症的最重要因素。临床医生在评估任何手部损伤时必须保持高度怀疑,手部握拳伤应通过早期充分的外科清创治疗,随后静脉注射青霉素,直至手术培养结果证实或排除腐蚀艾肯菌污染。