14例布鲁氏菌病性胸锁关节炎患者临床特点

Clinical characteristics of 14 patients with brucellosis sternoclavicular arthritis

摘要:

目的 总结布鲁氏菌病性胸锁关节炎患者临床症状、影像学表现、实验室检查特点, 为诊断及治疗提供参考。 方法 采用回顾性分析方法收集2013年8月—2023年2月呼伦贝尔市某医院布鲁氏菌科入院患者, 整理分析流行病学特点、首诊情况、临床表现、临床体征、实验室检查、影像学检查、治疗及预后情况。 结果 14例布鲁氏菌病性胸锁关节炎患者, 其中男性11例, 女性3例, 14例均有明确流行病学史。临床表现为关节疼痛(14例)、发热(10例)、乏力(10例)、多汗(6例)、寒战(5例)。临床体征以关节红肿痛(14例)、脾大(4例)、淋巴结肿大(3例)为主。实验检查异常以炎性指标升高为主, 其中C反应蛋白升高14例, 红细胞沉降率升高10例, 另伴有血液系统损伤、肝损伤。14例患者均给予12周及以上足疗程联合抗感染治疗, 其中治愈13例, 手术治疗1例, 有效率100%。 结论 布鲁氏菌病性胸锁关节炎发病率较低, 易出现误诊漏诊, 临床应注意鉴别, 若早发现、早诊断、早治疗, 临床预后较好。

Abstract:

Objective To summarize the clinical symptoms, imaging findings, and laboratory examination characteristics of patients with brucellosis sternoclavicular arthritis, and provide references for diagnosis and treatment. Methods Patients admitted to the brucellosis department of a hospital from August 2013 to February 2023 were analyzed retrospectively. The epidemiological characteristics, initial diagnosis, clinical manifestations, clinical signs, laboratory examinations, imaging examinations, as well as treatment and prognosis were analyzed. Results Among the 14 patients with brucellosis sternoclavicular arthritis, 11 were males and 3 were females, all of whom had a clear epidemiological history. Clinical manifestations included joint pain (n=14), fever (n=10), fatigue (n=10), hyperhidrosis (n=6), and chills (n=5). The main clinical signs were redness, swelling and pain of joints (n=14), splenomegaly (n=4), and lymphadenopathy (n=3). Abnormal laboratory examination results were mainly characterized by elevated inflammatory markers, with 14 cases showing elevated C-reactive protein (CRP) and 10 cases showing elevated erythrocyte sedimentation rate (ESR), accompanied by hematological and liver damage. All 14 patients received at least 12 weeks full course of anti-infection therapy, out of which 13 were cured and 1 underwent surgical treatment, with a 100% effective rate. Conclusion The incidence of brucellosis sternoclavicular arthritis is low, which is prone to misdiagnosis and missed diagnosis. Clinical attention should be paid to differential diagnosis. Early detection, diagnosis, and treatment lead to better clinical prognosis.