Propionibacterium acnes infection as an occult cause of postoperative shoulder pain: a case series.
Clin Orthop Relat Res
; 469(10): 2824-30, 2011 Oct.
Article
em En
| MEDLINE
| ID: mdl-21240577
ABSTRACT
BACKGROUND:
Infections after shoulder surgery are potentially devastating complications. Propionibacterium acnes is recognized as a causal agent in shoulder infections. The clinical presentation is usually insidious and nonspecific, but a P. acnes infection could be an occult cause of postoperative shoulder pain. QUESTIONS/PURPOSES:
What are the clinical and microbiologic characteristics of a postsurgical P. acnes shoulder infection and how should it be addressed? PATIENTS ANDMETHODS:
Ten patients with an average age of 57 years presented with P. acnes postsurgical shoulder infection. Clinical infection signs and surgical history were assessed and joint aspirates and tissue biopsy specimens were obtained. Diagnosis was confirmed by microbiologic cultures.RESULTS:
At the time of confirmation of the diagnosis, clinical signs of infection were absent. C-reactive protein and erythrocyte sedimentation rates were inconsistently elevated. Cultures took a mean 7 days to confirm organism growth. The average time from surgery to diagnosis of infection was 1.8 years (range, 0.07-8.0 years). All patients underwent irrigation and débridement and were treated with antibiotics for 6 weeks.CONCLUSIONS:
P. acnes shoulder infections should be considered as a cause for persistent, unexplained shoulder pain. Shoulder aspirations and tissue samples should be obtained. Surgical débridement and intravenous antibiotics are necessary treatment modalities. LEVEL OF EVIDENCE Level IV, Prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Dor Pós-Operatória
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Propionibacterium acnes
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Articulação do Ombro
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Infecção da Ferida Cirúrgica
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Dor de Ombro
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article