前十字韧带重建术后大芬戈尔德菌膝关节感染一例报告

Postoperative infection after anterior cruciate ligament reconstruction caused by Finegoldia magna:a case report

报告1例由革兰阳性厌氧菌大芬戈尔德菌导致的前十字韧带重建术后膝关节感染。患者在接受前十字韧带重建术后出现发热、膝关节疼痛、肿胀,通过病史、体格检查、影像学检查和第二代测序技术确诊为前十字韧带重建术后大芬戈尔德菌感染。通过文献复习,检索并分析了37篇大芬戈尔德菌感染性疾病的文献,同时回顾了厌氧菌的鉴定要点、第二代测序技术的应用和前十字韧带重建术后感染的治疗现状。关节镜下前十字韧带重建术后感染发生率较低,厌氧菌感染则更为罕见;厌氧菌培养困难,利用第二代测序技术可辅助诊断。在优先保留重建韧带的基础上,联合使用关节镜下清创引流冲洗术和敏感抗生素治疗为主。

One case of knee infection after anterior cruciate ligament reconstruction caused by the gram-positive anaerobic bacterium Finegoldia magna was reported.The patient was admitted to hospital due to fever and knee joint swelling and pain after anterior cruciate ligament reconstruction.Through medical history,physical examination,imaging examination and next-generation sequencing,it was confirmed that the infection was caused by Finegoldia magna.Through literature review,37 literatures on infectious diseases caused by Finegoldia magna was retrieved and analyzed,and the identification points of anaerobic bacteria,the application of second-generation sequencing technology and the treatment status of infection after anterior cruciate ligament reconstruction were reviewed.The incidence of infection after arthroscopic anterior cruciate ligament reconstruction is low,while anaerobic infection is even more rare and difficult to culture.The next-generation sequencing can be used to assist the diagnosis.On the basis of giving priority to the preservation of the reconstructed ligament,the combined use of arthroscopic debridement,irrigation and sensitive antibiotics is the main treatment method.