Crout J E, Brewer N S, Tompkins R B
Ann Intern Med. 1977 Mar;86(3):294-7. doi: 10.7326/0003-4819-86-3-294.
A review of the clinical features of seven patients with sporotrichosis arthritis showed that six had joint infection without previous skin or lung involvement and that one with myelofibrosis had joint and skin infection. The average time from onset of joint symptoms to diagnosis was 25 months, resulting in joint damage that required arthrodesis in four patients. Tissue from open synovial biopsy was superior to synovial fluid for obtaining a positive culture; concomitant synovial fluid and synovial tissue cultures were superior to either one alone. Granulomatous inflammation was seen in synovial tissue in six patients biopsied. Amphotericin B with surgical debridement of the affected joint was successful treatment in four patients. Although an uncommon cause of joint disease, sporotrichosis arthritis may go unrecognized and mimic other forms of arthritis, resulting in irreparable damage in an otherwise curable form of arthritis.
对7例孢子丝菌病关节炎患者临床特征的回顾显示,6例患者的关节感染之前无皮肤或肺部受累,1例患有骨髓纤维化的患者同时出现关节和皮肤感染。从关节症状出现到诊断的平均时间为25个月,导致4例患者出现关节损伤,需要进行关节融合术。开放滑膜活检组织在获得阳性培养结果方面优于滑液;同时进行滑液和滑膜组织培养比单独进行任何一种培养更具优势。在6例接受活检的患者的滑膜组织中可见肉芽肿性炎症。4例患者采用两性霉素B联合对受累关节进行手术清创治疗成功。尽管孢子丝菌病关节炎是关节疾病的罕见病因,但可能未被识别,并与其他形式的关节炎相似,从而导致一种原本可治愈的关节炎形式出现无法修复的损伤。