以髋关节、骶髂关节病变为首发症状的布鲁氏菌病一例报告  

Brucellosis with hip arthritis and sacroiliitis as the first symptoms:a report of one case

作　　者：张强[1] 夏璐 邓伟哲[1] 师国洋 钱春生 ZHANG Qiang;XIA Lu;DENG Wei-zhe;SHI Guo-yang;QIAN Chun-sheng(Department of Rheumatology and Traditional Chinese Medicine,The 962nd Hospital of the PLA,Harbin,Heilongjiang,150048,China)

机构地区：[1]中国人民解放军联勤保障部队第九六二医院中医风湿科,哈尔滨150048 [2]中国人民解放军联勤保障部队第九六二医院康复疼痛科,哈尔滨150048 [3]黑龙江省第二医院职业中毒科,哈尔滨150028

出　　处：《中国骨与关节杂志》2024年第3期237-240,共4页Chinese Journal of Bone and Joint

基　　金：哈尔滨市科技计划自筹经费项目(ZC2023ZJ004022);黑龙江省卫生健康委科技计划(20210303080312)。

摘　　要：布鲁氏菌病(brucellosis)是一种动物源性传染病(anthropozoonosis),由布鲁氏菌侵入机体所致,临床表现为发热、多汗、关节痛、肝脾及淋巴结肿大等[1]。疫畜及野生动物是布鲁氏菌病的主要传染源(source of infection),我国北方牧区以牛、羊为主要传染源[2]。Objective This article summarizes the key points distinguishing the brucellosis and ankylosing spondylitis based on literature review,providing clinical references.Methods We retrospectively reviewed a case of brucellosis in our hospital.Hip arthritis and sacroiliac arthritis were the initial symptoms,involving spinal joints.The initial diagnosis was ankylosing spondylitis,which was later corrected to brucellosis-related arthritis and spondylitis after further examinations.The patient received treatment with third-generation cephalosporins,rifampicin,and doxycycline combination therapy.Results X-ray and MRI images of the sacroiliac and hip joints showed similarities to those seen in ankylosing spondylitis cases.After 6 weeks of combined treatment,the patient’s symptoms improved significantly without disease progression or recurrence during follow-up.Conclusions Brucellosis and ankylosing spondylitis have distinct details in terms of laboratory tests,axial joint involvement,peripheral joint involvement,and radiographic changes.History of exposure along with pathogen testing is crucial for early identification and diagnosis of Brucellosis.

关 键 词：布鲁杆菌病 脊柱炎 强直性 骨关节炎 髋 骶髂关节炎 

分 类 号：R681.8[医药卫生—骨科学]