Le Dantec L, Maury F, Flipo R M, Laskri S, Cortet B, Duquesnoy B, Delcambre B
Department of Rheumatology, André Verhaeghe Center, Teaching Hospital, Lille, France.
Rev Rhum Engl Ed. 1996 Feb;63(2):103-10.
A retrospective medical record-based study of cases of peripheral pyogenic arthritis diagnosed in a rheumatology department between 1966 and 1993 was conducted. Of the 197 cases, 179 were evaluable. Pyogenic arthritis accounted for 0.68% of admissions and 30.3% of bone and joint infections during the study period. Incidence rose gradually from 2.2 new cases per year between 1966 and 1970 up to 6 to 10 new cases per year since 1991. In 88% of cases a single joint was involved, with the most commonly affected sites being the knee (32.5%), hip (22.2%), shoulder (12%) and sacroiliac joint (11.4%). Of the 22 patients with polyarticular arthritis, 19 had involvement of two joints. A portal of entry was identified in 53% of cases. Of the 13% of iatrogenic cases, half occurred after a local corticosteroid injection. The pathogen was identified in 65% of cases. Staphylococcus aureus was the most common organism (56%) followed by streptococci (9.5%) and E. coli (7%). Only three patients had gonococcal arthritis. Mean duration of therapy was four months. Although complications were exceedingly rare, three patients died and three others developed septic shock. Our data suggest that the presentation of pyogenic arthritis has remained essentially unchanged. In particular, we found no increase in iatrogenic forms, in contrast to recent experience with vertebral osteomyelitis.
我们进行了一项基于回顾性病历的研究，研究对象为1966年至1993年间在风湿科确诊的外周化脓性关节炎病例。在197例病例中，179例可进行评估。在研究期间，化脓性关节炎占入院病例的0.68%，占骨与关节感染病例的30.3%。发病率从1966年至1970年间每年2.2例新发病例逐渐上升，自1991年起每年达6至10例新发病例。88%的病例累及单个关节，最常受累的部位是膝关节（32.5%）、髋关节（22.2%）、肩关节（12%）和骶髂关节（11.4%）。在22例多关节性关节炎患者中，19例累及两个关节。53%的病例可确定感染入口。在13%的医源性病例中，半数发生在局部注射皮质类固醇激素之后。65%的病例可鉴定出病原体。金黄色葡萄球菌是最常见的病原体（56%），其次是链球菌（9.5%）和大肠杆菌（7%）。只有3例患者患有淋菌性关节炎。平均治疗时间为4个月。尽管并发症极为罕见，但有3例患者死亡，另有3例发生感染性休克。我们的数据表明，化脓性关节炎的表现基本未变。特别是，与近期脊椎骨髓炎的情况相反，我们发现医源性形式并未增加。
