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[成人关节感染。常见细菌和结核杆菌引起的外周关节及脊柱感染]

[Articular infections in adults. Peripheral and vertebral involvement with common bacteria and tubercle bacteria].

作者信息

David-Chaussé J, Dehais J, Boyer M, Darde M L, Imbert Y

出版信息

Rev Rhum Mal Osteoartic. 1981 Jan;48(1):69-76.

PMID:7221429
Abstract

2,166 cases of joint infection in adults were reviewed during a national inquiry. The peripheral infections due to common germs (1,080 cases) and tubercle bacilli (260 cases) were characterised by their frequency after the age of 60, the role of corticotherapy in onset of the infection and the predominance of staphylococci (60%) in pyogenic infections, the low proportion of deaths (4%) and the necessity of early treatment to observe better functional results. The vertebral lesions due to common bacteria (491 cases) were mainly localised in the lumbar regions (70%) whereas tuberculous infections (335 cases) usually affect the lower dorsal vertebrae (50%). Neurological signs and abscess were more frequent during tuberculous involvement. Needle puncture of the vertebral focus should be recommended owing to its help in etiological diagnosis. A cure was generally obtained without operation in the form of complete or incomplete block, this appearance is, however, less frequent than radiological signs of fixed osteolysis. The mortality is just as low as in peripheral infections.

摘要

在一项全国性调查中,对2166例成人关节感染病例进行了回顾性研究。由常见病菌引起的外周感染(1080例)和结核杆菌引起的外周感染(260例)的特点是:60岁以后发病率较高;皮质激素治疗在感染发病中的作用;化脓性感染中葡萄球菌占主导(60%);死亡率较低(4%);早期治疗对于获得更好的功能恢复很有必要。由常见细菌引起的脊柱病变(491例)主要位于腰椎区域(70%),而结核感染(335例)通常累及下胸椎(50%)。结核感染时神经症状和脓肿更为常见。由于有助于病因诊断,建议对脊柱病灶进行穿刺。一般通过完全或不完全阻滞的形式,无需手术即可治愈,不过这种表现不如骨质溶解性固定的放射学征象常见。死亡率与外周感染一样低。

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