A case of unusual Gram-negative bacilli septic arthritis in an immunocompetent patient
A case of unusual Gram-negative bacilli septic arthritis in an immunocompetent patient
复制标题
DOI：
10.11622/smedj.2013162
复制
发表时间：
2013-08-01
影响因子：
2.7
通讯作者：
Wang, Wilson
中科院分区：
文献类型：
--
作者：
Chiu, Li Qi;Wang, Wilson
革兰氏阴性杆菌鲍曼不动杆菌、葡萄伯克氏菌、人类嗜铬杆菌、mendocina假单胞菌、Ralstonia spp、粘质沙雷氏菌和嗜麦芽窄养单胞菌是普遍存在的低毒力环境生物，通常不会在免疫能力强的宿主中引起疾病。我们报告一例多重并发机会性革兰氏阴性杆菌引起脓毒性关节炎在一个健康的病人创伤后的膝盖。反复手术，包括关节镜检查，关节切开术和清创，在组织培养变为阴性之前。该患者在出院前还需要延长静脉和口服抗生素治疗的时间。革兰氏阴性细菌性败血性关节炎是一种罕见但重要的疾病，需要反复清创和冲洗以达到细菌根除。本病例报告强调了在受伤时了解外部环境的重要性，因为它会影响引起感染的生物体类型，从而影响成功治疗所需的经验性抗生素的选择。
The Gram-negative bacilli Acinetobacter baumannii, Burkholderia cepacia, Ochrobactrum anthropi, Pseudomonas mendocina, Ralstonia spp., Serratia marcescens and Stenotrophomonas maltophilia are ubiquitous environmental organisms of low virulence, and do not usually cause illness in immunocompetent hosts. We report a case of multiple concurrent opportunistic Gram-negative bacilli causing septic arthritis in a healthy patient following trauma to the knee. Repeated operations, including arthroscopy, arthrotomy and debridement, were required before tissue cultures became negative. The patient also required an extended duration of intravenous and oral antibiotic treatment before he was discharged. Gram-negative bacillary septic arthritis is an uncommon but significant condition that requires repeated debridement and washouts in order to achieve bacterial eradication. This case report highlights the importance of an awareness of the external environment at the time of injury, as it impacts the type of organisms causing the infection, and consequently, the choice of empiric antibiotics required for successful treatment.