摘要
Abstract
Objective To assess the clinical features of connective tissue disease(CTD) combined with salmonella arthritis and osteomyelitis.Methods The clinical manifestations,laboratory findings,diagnosis,treatment and prognosis of 11 patients with CTD with salmonella arthritis and osteomyelitis were retrospectively analyzed,including 1 from Ningbo First Hospital and 10 reported by articles.Results The main data of the 11 cases were as follows:6 were accompanied with systemic lupus erythematosus (SLE),4 were with rheumatoid arthritis (RA),1 was with adults-onset Still's disease (AOSD);all received long-term treatment with corticosteroids or immunosuppressive agents,and before the onset of the disease,the 4 RA cases received treatment with biological agents,3 underwent joint replacement,2 patients had a history of unclean diet, 1 had a fatigue history;common clinical manifestations:all had bone pain,9 had fever and 2 had digestive tract symptoms;site of involvement:long bone of the lower extremity(6 cases),the hip joint(3 cases),pubic symphysis(1 case), left elbow(1 case);laboratory findings:the level of CRP increased to varying degrees in all cases with the average level of (132.0±26.2) mg/L,the WBC level was normal in 9 cases,elevated in 2 cases;pathogenic bacteria:3 were infected by salmonella enteritidis,2 by salmonella tphimurium,1 by group D salmonella,and 1 by nontyphoid salmonella;accessory examination:bone biopsy was performed in 3 cases,the others underwent joint aspiration or synovial biopsy combined with imaging examination;treatment:all were treated with antibiotics,6 of them additionally received surgery;outcome:5 were cured,1 had recurrence,3 had bone/joint dysfunction.Conclusion CTD with salmonella osteomyelitis is not rare,especially in SLE.It is mostly caused by long period use of corticosteroids and immunosuppressive agents,and may also caused by the treatment with biological agents and joint replacement surgery.Long bone of the lower extremity is the most common affected site,and elevated CRP level can often be found.The disease has a high disability rate,so early detection and active treatment are needed.关键词
结缔组织疾病/沙门菌属/骨及关节感染/临床特点Key words
Connective tissue disease/Salmonella/Bone and joint infection/Clinical characteristics分类
医药卫生
