多杀巴斯德菌致化脓性膝关节炎1例并文献复习  

Suppurative knee arthritis caused by Pasteurella multocida:a case report and literature review

作　　者：赵亚虹 张莎娜 李弈 胥俊越 ZHAO Yahong;ZHANG Shana;LI Yi;XU Junyue(Beijing Electric Power Hospital,State Grid Corporation,Beijing 100073,China)

机构地区：[1]国家电网公司北京电力医院,北京100073

出　　处：《中国热带医学》2023年第9期1007-1010,共4页China Tropical Medicine

摘　　要：目的 报道1例多杀巴斯德菌感染致化脓性膝关节炎的病例,以提高临床医生对该菌的认识,为临床诊断治疗提供参考。方法 回顾性分析2018年3月收入国家电网公司北京电力医院骨科的1例感染多杀巴斯德菌致右膝化脓性关节炎的病例,并对相关文献进行复习。结果 患者,女,76岁,有5年右膝间断疼痛史,于门诊就诊诊断为骨性关节炎,予关节腔内注射玻璃酸钠等治疗。后因右膝关节出现关节肿胀、疼痛加重、屈伸活动受限的症状,办理入院。入院后完善各项检查,明确右膝为多杀巴斯德菌感染,及时行手术,包括关节镜下右膝探查、关节清理术、滑膜与半月板切除术、引流管置入术,术后持续关节腔冲洗,先后注射头孢曲松及口服阿莫西林/克拉维酸钾进行抗感染治疗,26 d后患者感染得到控制,病情明显好转之后办理出院。结论 多杀巴斯德菌感染病例较少见,但高危人群感染后却比较严重,所以临床医生应提高对该菌及其所引起感染的认知,尽早发现感染致病菌,予以对症治疗。高危人群应尽量避免接触感染源,以免感染。Objective To report a case of suppurative knee arthritis caused by Pasteurella multocida and review relevant literature to improve the awareness of the clinical physicians regarding this bacterium and provide reference for clinical diagnosis and treatment.Methods A case of right knee suppurative arthritis caused by Pasteurella multocida was retrospectively reported and relevant literatures were reviewed in this article.Results The infected person was a 76-year-old female patient with a 5-year history of intermittent pain in his right knee and suffered from joint swelling,aggravation pain,and limited flexion and extension activities after intraarticular injection of sodium hyaluronate.After admission and completing all necessary tests,the patient was later confirmed to have been infected with Pasteurella multocida.The patient′s right knee was promptly examined and cleared under arthroscopic surgery,synovium and meniscus were excised,a drainage tube was inserted,and continuous joint cavity irrigation was performed after the surgery,and then ceftriaxone was injected and amoxicillin/clavulanate potassium was taken orally for anti-infection and the patient′s condition improved significantly after 26 days.Conclusions Pasteurella multocida infection cases are relatively rare,but the consequences in high-risk groups are relatively serious.Therefore,awareness of Pasteurella multocida and infection caused by it should be improved and high-risk groups should try to avoid contact with infectious sources as well as strengthen the management of pets so as to avoid infection.

关 键 词：多杀巴斯德菌 人畜共患病 化脓性膝关节炎 

分 类 号：R516[医药卫生—内科学]