Brachial Plexus Neuropathy Secondary to Septic Arthritis and Osteomyelitis: Report of Two Cases

化膿性關節炎及骨髓炎引起之臂神經叢病變—兩病例報告

王允中(Yun-Chung Wang) ； 林福坤(Fu-Kun Lin) ； 洪焜隆(Kun-Long Hung) ； 吳德洋(Der-Yang Wu)

《Acta Paediatrica Sinica》 35卷5期 (1994/10) Pp. 449-454

https://doi.org/10.7097/APS.199410.0449

摘要

我們提出兩例生產過程順利但稍反卻因右肩化膿性關節炎及右肱骨髓炎繼發右臂神經叢病變的罕見報告。兩位病嬰各在出生第六天及第十天大時出現右臂無力現象，觸診及被動性活動右臂時均有疼痛感，右肩關節X光攝影均出現右肱骨頭近側聞風而端不規則顯影，右肩關節抽出液細菌培養分別長出草綠色鏈球菌及金黃色葡萄球菌。此二病例之肌電圖顯示不同程度C5到C7神經所支配肌肉明顯去神經化現象。經過抗生素治療、關節切開引流及復建治療後，右手臂無力現象漸改善。病人六個月大時門診追蹤發現其中一位病人右手臂功能幾乎完全復原，而另一位病人則有輕度無力現象。肌電圖追蹤檢查也都顯示持續復原中。

關鍵字

臂神經叢病變 ； 化膿性關節炎 ； 骨髓炎

並列摘要

Two infants, delivered uneventfully, later developed right brachial plexus palsy secondary to pyogenic osteomyelitis and arthritis of the right shoulder joint. Weakness of right arms occurred at the sixth and tenth days of age respectively. Both had right arm tenderness on palpation and passive movement. Roentgenograms of their right shoulder joints showed irregular radiolucency of the proximal margin of right humerous head. In both cases, electromyography revealed various degrees of significant denervation pattern for the C5-C7 innervated muscles. Pus culture from right shoulder joints grew Streptococcus viridans and Staphylococcus aureus, respectively. After antibiotic therapy and arthrotomy with drainage, weakness improved gradually following continuous rehabilitation. Follow-up at six months of age showed almost complete in the other. Follow-up electromyography studies showed continued improvement. The possible mechanism of this rare occurrence is discussed.

並列關鍵字

brachial plexus neuropathy ； septic arthritis ； osteomyelitis