細菌性骶髂關節炎－二病例報告

細菌性骶髂關節炎是很罕見的疾病。本報告提出最近二年在本院住院經診斷為細菌性骶髂關節炎，並治癒的病例二例。甲例是22歲男性，因高燒及左臀部劇痛而住院，其X光及同位素骨掃描檢查有明顯之左骶髂關節發炎之徵象，血液細菌培養分離出金黃色葡萄球菌。病人住院後接受oxacillin靜注，每日6gm分6次給藥，共4週，接著口服cephalexin 2週。患者於一週內發燒消退，左臀疼痛也漸消失，於住院後6週出院。四個月後複查其骨盆X光片仍呈現骶髂關節面變寬及模糊之現象。乙例是58歲女性，因右臀部疼痛8天求診而住院。其X光以及同位素骨掃描檢查均有異常發現。在超音波的指引下，以針自該病人之右骶髂關節抽出膿液5ml，其細菌培養確定為乙族鏈球菌。該患者於接受青黴素每日一千八百萬單位，分6次，靜注2週，接著口服ampicillin 1週後出院。該二例患者都因正確的診斷及即時而適當的治療而痊癒。

關鍵字

細菌性骶髂關節炎

並列摘要

Pyogenic infection of the sacroiliac joint is a rare disease entity. The diagnosis of pygoenic sacroiliitis is rather difficult and always delayed. We present two cases of pyogenic sacroiliitis which were diagnosed and treated at our hospital in the past two years. Case 1 was a 22-year-old male, admitted with left buttock pain and high fever. The roentgenographic finding and Tc^(99m) MDP bone scan both revealed definite abnormality of the left sacroiliac joint. Staphylococcus aureus was isolated from blood cultures. He received intravenous oxacillin therapy for 4 weeks, followed by oral cephalexin for 2 weeks. The fever subsided within one week, and the buttock pain gradually resolved. He was discharged in good condition 6 weeks after admission. Four months later, a follow-up pelvic film still disclosed pseudo-enlargement and a blurred margin of the left sacroiliac joint space. Case 2 was a 58-year-old female, admitted with complaints of right buttock pain for 8 days. Both the roentgenographic finding and Tc^(99m) MDP bone scan showed pathological change of the right sacroiliac joint. She received aspiration of the joint under sono-guidance during which about 5 ml of pus was aspirated. Group B beta-streptococcus was isolated and she received intravenous penicillin G treatment for 2 weeks, followed by oral ampicillin for one week. She was discharged after the symptoms resolved. Both cases were cured following effective and immediate therapy as a result of correct diagnosis.

並列關鍵字

Bacterial sacroiliitis

國際替代計量

細菌性骶髂關節炎－二病例報告

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