李玲 马永峰 杜叶平 贾沛洲 靳志勇

[摘要]回顾收住入院的1例肠炎沙门菌感染致关节脓肿患者的临床资料，并对诊断过程进行相关分析。部分患者感染肠炎沙门菌的临床表现不典型，因此，当患者出现不明原因发热、关节肿胀疼痛时，临床应及时采集血液、骨髓或局部标本做细菌培养以明确病原菌。体外药敏试验结果提示喹诺酮类抗菌药物敏感，然而患者使用该药可能无效，需及时调整抗菌药物。肠炎沙门菌感染引起化脓性骨关节感染的情况较为少见，容易引起误诊误治，早期确诊和药敏试验是治疗成功的基础。可根据药敏试验选择不同的抗生素治疗，为今后诊疗肠炎沙门菌感染致关节脓肿提供一定的参考。[关键词]肠炎沙门菌;关节脓肿;感染性;药敏试验

[中图分类号] R516.3 [文献标识码] A  [文章编号]2095-0616（2021）22-0238-04

Study on one case of joint abscess caused by salmonella enteritidis

LI  Ling   MA  Yongfeng   DU  Yeping   JIA  Peizhou   JIN  Zhiyong

Department of Clinical Laboratory， 985th Hospital ofThe Joint Logistic Support Force， Shanxi， Taiyuan 030001， China

[Abstract] This paper reviewed the clinical data of one case of joint abscess caused by salmonella enteritidis infection admitted to our hospital， and analyzed the diagnostic process in relation to the case. Some patients had atypical clinical manifestations of Salmonella enterica infection. Therefore， when patients presented with unexplained fever and joint pain and swelling， the blood， bone marrow or local specimens should be collected promptly for bacterial culture to clarify the pathogenic bacteria. The results of drug sensitivity test in vitro suggested that quinolones antibacterial drugs had a certain of sensitivity， however， they may be ineffective for patients， and therefore， antibacterial drugs should be adjusted in time. Salmonella enteritidis infection resulting in septic osteoarthritis infection is rare and prone to misdiagnosis and mistreatment， and therefore， early confirmation of diagnosis and drug sensitivity test is the basis of successful treatment. The selection of different antibiotic courses according to the drug sensitivity test can provide some reference for the future diagnosis and treatment of joint abscess caused by salmonella enteritidis infection.

[Key words] Salmonella enteritidis; Joint abscess; Infectivity; Drug sensitivity test

沙门菌属是肠杆菌科中的一个菌属，其有2600多个血清型，是危害人类和动物健康的重要致病菌。肠炎沙门菌是沙门菌属的一个血清型，属于无宿主特异性而有侵害性的病原菌之一，主要通过污染食品和水源的方式感染宿主，从而引起胃肠炎、败血症、菌血症和肠热症。在其疾病过程中或恢复期引起化脓性骨关节感染的情况较为少见，肠炎沙门菌感染导致骨髓炎的情况更是罕见[1-4]。经我院医学伦理委员会批准，回顾2020年3月收住入院的1例肠炎沙门菌感染致关节脓肿患者的临床资料，对诊斷过程进行分析，探讨肠炎沙门菌感染致关节脓肿的诊断方法，现报道如下。……