社区获得性耐甲氧西林金黄色葡萄球菌感染导致的急性化脓性骨髓炎1例并文献分析

摘要

Objective To strengthen cognition of acute suppurative osteomyelitis and CA-MRSA infection by analyzing the case of 1 patient with acute suppurative osteomyelitis caused by community-acquired methicillin-resistant staphylococcus aureus CA-MRSA infection. Methods To conduct retrospective analysis of clinical data of 1 patient with acute suppurative osteomyelitis caused by community-acquired methicillin-resistant staphylococcus aureus CA-MRSA infection treated in ICU of Cardiovascular Diseases Hospital of General Hospital of Ningxia Medical University. To summarize changes of clinical symptoms before and after treatment, lab test and iconography test so as to improve diagnosis and treatment effect. Results Clinical manifestations of typical CA-MRSA infection like high fever, blood line infection and empyema etc appears in the patient. The patient accept drug therapy including teicoplanin and linezolid, combined with drainage by thoracocentesis, marrow drilling convection lfushing technique, leading to clear diagnosis and signiifcant treatment effect. Conclusion Clinicians should raise awareness of acute suppurative osteomyelitis caused by community-acquired methicillin-resistant staphylococcus aureus, with early accurate diagnosis and correct anti-infective therapy to increase patients’cure rate.%目的：通过对1例由社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）感染引起的急性化脓性骨髓炎病例的分析，增强对急性化脓性骨髓炎及CA-MRSA感染的认识。方法对宁夏医科大学总医院心脑血管病医院ICU收治的1例CA-MRSA感染导致的急性化脓性骨髓炎病例的临床资料进行回顾性分析，总结其治疗前后临床症状、实验室检查、影像学检查的变化，提高其诊断和治疗效果。结果患者出现了高热、血行感染、脓胸等典型的CA-MRSA感染的临床表现，在接受了替考拉宁、利奈唑胺等药物治疗的同时，联合胸腔穿刺引流及骨髓钻孔开窗对流冲洗术，其诊断明确，治疗效果显著。结论临床医师应该提高对社区获得性耐甲氧西林金黄色葡萄球菌感染引起的急性化脓性骨髓炎的认识，早期、正确诊断，并予以正确的抗感染治疗，提高患者的治愈率。