化脓性腱鞘炎的最新进展

IF 3.1 4区 医学 Q2 INFECTIOUS DISEASES
Wissam El Atrouni, Mitchell C. Birt, Rachel Weihe
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引用次数: 0

摘要

最近的研究结果感染性腱鞘炎主要由葡萄球菌、链球菌、革兰氏阴性菌以及咬伤后的埃克菌和巴氏杆菌引起。非典型菌(尤其是免疫力低下的患者)的报告越来越多,如真菌、生长缓慢或迅速的分枝杆菌。保守治疗可采用静脉注射抗生素和密切监测的方法,尤其是在轻症病例中。腱鞘炎是一种腱鞘感染。接种通常发生在受伤、穿刺伤口、咬伤、近期手术后,或通过血源性或毗连性感染传播。在评估患者时,Kanavel 体征很有帮助。应立即咨询手外科医生,以决定是否需要进行手术探查。不复杂的病例可口服抗生素 7 至 14 天。吸烟、糖尿病、血管疾病和晚期 Michon 阶段感染与截肢或活动能力下降的风险较高有关。在治疗真菌性和霉菌性腱鞘炎等非典型表现时,应咨询传染病专家。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

An Update on Suppurative Tenosynovitis

An Update on Suppurative Tenosynovitis

Purpose of Review

Suppurative tenosynovitis is a serious infection mostly affecting the flexor tendons of the hand and is considered a medico-surgical emergency.

Recent Findings

Infectious tenosynovitis is mostly caused by Staphylococci, Streptococci, Gram negatives, and following bite injury, Eikenella and Pasteurella species. Atypical organisms especially in immunocompromised patients are increasingly being reported like fungi and slowly or rapidly growing mycobacteria. Management can be conservative with intravenous antibiotics and close monitoring especially in mild cases. Minimally invasive catheter irrigation of the tendon sheath can be used with improved functional outcomes.

Summary

Suppurative tenosynovitis is an infection of the tendon sheath. Inoculation usually occurs following injury, puncture wounds, bites, recent surgery, or via hematogenous or contiguous spread of infection. Kanavel signs are helpful when evaluating patients. Hand surgeons should be promptly consulted for decision about need for surgical exploration. Uncomplicated cases can be treated with 7 to 14 days of an oral antibiotic. Smoking, diabetes, vascular disease, and advanced Michon stage infection are associated with higher risk of amputation or decreased mobility. Infectious diseases specialists should be consulted in the management of atypical presentations like fungal and mycobacterial tenosynovitis.

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来源期刊
Current Infectious Disease Reports
Current Infectious Disease Reports INFECTIOUS DISEASES-
CiteScore
6.70
自引率
0.00%
发文量
19
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of infectious disease. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as HIV/AIDS, sexually transmitted diseases, tropical and travel medicine, and urinary tract infections. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists.
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