Clinical practice. Infection associated with prosthetic joints.
Clinical practice. Infection associated with prosthetic joints.
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DOI：
10.1056/nejmcp0905029
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发表时间：
2009-08-20
期刊：
影响因子：
--
通讯作者：
Patel R
中科院分区：
文献类型：
--
作者：
Del Pozo JL;Patel R
一位62岁的女性骨性关节炎患者，在接受全左髋关节置换术8个月后，有7个月的左髋关节疼痛逐渐加重的病史，并辐射至腹股沟。疼痛对非类固醇抗炎药没有反应。体格检查显示她的左髋部有一条窦道。她的白细胞计数是每立方毫米8000个，C反应蛋白(CRP)水平是每升15.5毫克。X光片显示假体在骨水泥界面处松动。关节液抽吸物显示每立方毫米有15×103个细胞(89%的中性粒细胞)；髋部抽吸物的培养物可培养出表皮葡萄球菌。她的案件应该如何处理？
A 62-year-old woman with osteoarthritis presents with a 7-month history of progressively worsening left hip pain radiating to the groin, 8 months after undergoing total left-hip arthroplasty. The pain has not responded to nonsteroidal antiinflammatory drugs. Physical examination reveals a sinus tract overlying her left hip. Her leukocyte count is 8000 per cubic millimeter, and the C-reactive protein (CRP) level is 15.5 mg per liter. A radiograph shows loosening of the prosthesis at the bone–cement interface. Synovial-fluid aspirate shows 15×103 cells per cubic millimeter (89% neutrophils); cultures of an aspirate from the hip grow Staphylococcus epidermidis. How should her case be managed?