在长期,固定良好的植入物中与植入物相关的Mycobacterium结核病感染 (IMTI)
Latif Zafar Jilani1, Mohammad Istiyak1, Madhav Chowdhry1
1Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, 202002, Uttar Pradesh, India.
Journal of clinical orthopaedics and trauma
|September 19, 2024
概括
骨科植入物中的结核病感染是罕见的. 植入物相关的Mycobacterium结核病感染 (IMTI) 的成功治疗包括手术除菌和18个月的抗结核化疗,允许植入物保留.
科学领域:
- 整形外科 整形外科 整形外科
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 植入物相关的Mycobacterium结核病感染 (IMTI) 是罕见的,由于粘附性差和生物膜形成存在挑战.
- 由Mycobacterium tuberculosis引起的周围假肢关节感染 (PJI) 不常见.
研究的目的:
- 展示了两例植入物相关的Mycobacterium结核病感染 (IMTI) 的成功治疗方法.
- 要突出手术脱bridement和长期抗结核化疗在管理IMTI与植入物保留的有效性.
主要方法:
- 治疗了两例培养阴性PJI和植入物相关感染病例.
- 进行了细致的手术脱bridement,保留了植入物.
- 使用CB-NAAT和组织病理学分析了手术内深层组织样本.
- 患者接受了18个月的抗结核治疗 (ATT).
主要成果:
- 两位患者均呈现异常,晚发性排泄鼻和负初始培养.
- 在手术期间的样本通过CB-NAAT和组织病理学证实了Mycobacterium结核菌感染.
- 这两种病例都显示了成功的治疗结果与植入物保留在2年的随访.
结论:
- 非典型的,晚发性排泄鼻与负面培养应引起IMTI的怀疑.
- 在诊断IMTI时,手术内样本的CB-NAAT和组织病理学是至关重要的.
- 精细的除菌与18个月的ATT相结合,是IMTI的可行治疗选择,可使假肢保持.
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