Spagnuolo P J
Am J Med Sci. 1978 May-Jun;275(3):359-63. doi: 10.1097/00000441-197805000-00014.
Pasteurella multocida, a small gram-negative rod, is a domestic animal saprophyte that occasionally causes disease in humans. Infectious arthritis may develop from a superficial animal bite or scratch. Nine previous cases of infectious arthritis due to this organism have been documented in the literature, and a tenth case is reported here. Most patients had recent animal exposure, and half the patients had underlying chronic rheumatoid arthritis. Clinical signs of inflammation were consistently present; however, systemic infection was infrequent. The lack of positive synovial fluid gram-stain smears may make differentiation from other forms of infectious arthritis difficult. Penicillin in moderate doses is effective therapy, with osteomyelitis developing in only two patients. The tendency for this syndrome to affect patients with rheumatoid arthritis may reflect deficient local defense mechanisms, chronic steroid therapy, or increased ownership of pets. The mechanism of spread of infection to the joint space appears to be through contiguous spread from a skin site rather than by the hematogenous route in most cases.
多杀巴斯德菌是一种革兰氏阴性小杆菌，是家畜腐生菌，偶尔可导致人类发病。感染性关节炎可能由体表动物咬伤或抓伤引起。此前文献已记载9例由该病菌导致的感染性关节炎病例，本文报告第10例。大多数患者近期接触过动物，半数患者患有潜在的慢性类风湿性关节炎。炎症的临床体征始终存在；然而，全身性感染并不常见。滑膜液革兰氏染色涂片未呈阳性可能会使与其他形式的感染性关节炎相鉴别变得困难。中等剂量的青霉素是有效的治疗方法，仅两名患者发生了骨髓炎。该综合征易影响类风湿性关节炎患者的倾向可能反映了局部防御机制不足、长期使用类固醇治疗或宠物饲养增多。在大多数情况下，感染扩散至关节腔的机制似乎是从皮肤部位直接蔓延，而非血行途径。
