全膝关节置换术后布鲁氏菌混合感染1例

doi:10.3877/cma.j.issn.1674-134X.2025.03.018

中华关节外科杂志(电子版) ›› 2025, Vol. 19 ›› Issue (03) : 387 -390. doi: 10.3877/cma.j.issn.1674-134X.2025.03.018

个案报道

全膝关节置换术后布鲁氏菌混合感染1例

李嘉欢¹^,², 乔永杰¹^,³, 李培杰¹^,², 谭飞¹^,², 曾健康¹^,², 林志强¹^,², 张凯¹^,², 宋晓阳¹, 周胜虎¹^,^†(

)

¹730050　兰州，解放军联勤保障部队第九四〇医院关节外科
²730000　兰州，甘肃中医药大学第一临床医学院
³730030　兰州大学第二临床医学院

收稿日期:2024-11-14 出版日期:2025-06-01
通信作者: 周胜虎
基金资助:
甘肃省重点研发计划(25YFFA065); 甘肃省卫生健康行业科研项目(GS-62000000025-2024-068); 联勤保障部队第九四〇医院高层次人才培养工程(2024-G3-5)

Case report on mixed infection of Brucella following total knee arthroplasty

Jiahuan Li, Yongjie Qiao, Peijie Li

Received:2024-11-14 Published:2025-06-01

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图1 左侧全膝关节置换术后假体松动感染进程及治疗。图A～B为术前左膝关节X线正侧位片，示假体部分松动；图C为左膝关节TKA术后切口渗出流脓，窦道形成；图D为术中左膝关节腔大量脓液及坏死组织，探查胫骨及股骨假体部分松动；图E为术中左膝关节假体取出、清创彻底；图F为抗生素骨水泥占位器注：翻修手术关键步骤为术前影像→切口窦道→脓液清理→假体取出→占位器置入

图2 左侧全膝关节旷置术后影像、大体观、病理及布鲁氏菌染色结果。图A为左膝关节抗生素骨水泥旷置术后X线正侧位片，示固定器在位；图B为左膝关节旷置术后大体观；图C ～D为患膝滑膜病理切片苏木素-伊红染色（×100），示多量纤维素性渗出物和肉芽组织增生；图E～G为布鲁氏菌革兰氏染色和瑞氏染色，示阳性结果

图3 左膝关节二期翻修术前、术后影像及功能活动度观察。图A～B为二期翻修术前左膝关节X线正侧位片；图C～E为二期翻修术后左膝关节及左下肢全长X线片；图F～H为二期翻修术后患膝关节屈伸大体观

[1]	李嘉欢,乔永杰, 曾健康, 等. 磨损颗粒诱导人工关节置换术后假体无菌性松动相关生物学机制的研究进展[J]. 中华骨与关节外科杂志, 2024, 17（8）: 755-761.
[2]	Osmon DR, Berbari EF, Berendt AR, et al. Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America[J/OL]. Clin Infect Dis, 2013, 56（1）: e1-e25. DOI:10.1093/cid/cis803.
[3]	Tande AJ, Patel R. Prosthetic joint infection[J]. ClinMicrobiol Rev, 2014, 27（2）: 302-345.
[4]	Rizkalla JM, Alhreish K, Syed IY. Spinal brucellosis: acasereport and review of the literature[J]. J Orthop Case Rep, 2021, 11（3）: 1-5.
[5]	Unuvar GK, Kilic AU, Doganay M. Current therapeutic strategy in osteoarticular brucellosis[J]. North ClinIstanb, 2019, 6（4）: 415-420.
[6]	Zangeneh M, Rezvanfar K, Khosravani-Nejad Y, et al. Infection of tendon sheaths, joints, bursae, soft tissue, and tendon rapture by Brucella: a case report[J/OL]. Clin Case Rep, 2023, 11（11）: e8157. DOI:10.1002/ccr3.8157.
[7]	Suo B, He J, Wu C, et al. Comparison of different laboratory methods for clinical detection of Brucella infection[J]. Bull ExpBiol Med, 2021, 172（2）: 223-227.
[8]	Weil Y, Mattan Y, Liebergall M, et al. Brucella prosthetic joint infection: a report of 3 cases and a review of the literature[J/OL]. Clin Infect Dis, 2003, 36（7）: e81-6. DOI:10.1086/368084.
[9]	Hughes HC, Newnham R, Athanasou N, et al. Microbiological diagnosis of prosthetic joint infections: a prospective evaluation of four bacterial culture media in the routine laboratory[J]. Clin Microbiol Infect, 2011, 17（10）: 1528-1530.
[10]	Shakir R. Brucellosis[J/OL]. J Neurol Sci, 2021, 420: 117280.DOI:10.1016/j.jns.2020.117280.
[11]	Kim SJ, Park HS, Lee DW, et al. Brucella infection following total joint arthroplasty: a systematic review of the literature[J]. Acta Orthop Traumatol Turc, 2018, 52（2）: 148-153.
[12]	Almirón MA, Roset MS, Sanjuan N. The aggregation of Brucella abortusoccurs under microaerobicconditions and promotes desiccation tolerance and biofilm formation[J]. Open Microbiol J, 2013, 7: 87-91.
[13]	Lewis JM, Folb J, Kalra S, et al. Brucella melitensis prosthetic joint infection in a traveller returning to the UK from Thailand: case report and review of the literature[J]. Travel Med Infect Dis, 2016, 14（5）: 444-450.
[14]	Traxler RM, Lehman MW, Bosserman EA, et al. A literature review of laboratory-acquired brucellosis[J]. J Clin Microbiol, 2013, 51（9）: 3055-3062.
[15]	Egerci OF, Yapar A, Dogruoz F, et al. Preventive strategies to reduce the rate of periprosthetic infections in total joint arthroplasty; a comprehensive review[J]. Arch Orthop Trauma Surg, 2024, 144（12）: 5131-5146.

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