Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Πέμπτη 19 Οκτωβρίου 2017

Gentamicin-vancomycin-colistin local antibiotherapy in a cement spacer in a 54-year-old haemophilic patient with relapsing plurimicrobial severe prosthetic joint infection

Description

A 54-year-old patient with haemophilia and hepatitis C virus infection experienced acute left prosthetic joint infection due to Klebsiella pneumoniae and Staphylococcus aureus following unipolar exchange in September 2015. As the outcome was not favourable with bloody discharge despite haemophilic factor substitution, a new local debridement was performed in May 2016 and multidrug-resistant Enterobacter asburiae (only susceptible to imipenem, colistin, amikacin and fosfomycin) and Corynebacterium striatum (only susceptible to vancomycin, rifampin and linezolid) grew in cultures. As explantation was considered too risky due to the potential bleeding, systemic intravenous treatment was proposed with imipenem (3 g/day), vancomycin (2.5 g/day) and fosfomycin (12 g/day). After 3 months of therapy, the bloody discharge persisted. One month after discontinuation of antibiotics, the patient presented a large 'bourgeon charnu' with impressive bloody discharge (figure 1A). X-ray revealed trochanter osteolysis, without prosthesis loosening (figure 1B). Prosthesis explantation was performed, and a...



http://ift.tt/2xTezPN

Δεν υπάρχουν σχόλια:

Δημοσίευση σχολίου