Deep Infection Caused by Gas-Forming Bacteria after Total Hip Arthroplasty

인공 고관절 전치환술 후 가스 형성균에 의한 심부 감염

  • Kim, Yong-Sik (Department of Orthopedic Surgery, The Catholic University of Korea, School of Medicine) ;
  • Woo, Young-Kyun (Department of Orthopedic Surgery, The Catholic University of Korea, School of Medicine) ;
  • Lee, Kyung-Jin (Department of Orthopedic Surgery, The Catholic University of Korea, School of Medicine) ;
  • Boo, Ki-Hyun (Department of Orthopedic Surgery, The Catholic University of Korea, School of Medicine) ;
  • Kwon, Soon-Yong (Department of Orthopedic Surgery, The Catholic University of Korea, School of Medicine)
  • 김용식 (가톨릭대학교 의과대학 정형외과학교실) ;
  • 우영균 (가톨릭대학교 의과대학 정형외과학교실) ;
  • 이경진 (가톨릭대학교 의과대학 정형외과학교실) ;
  • 부기현 (가톨릭대학교 의과대학 정형외과학교실) ;
  • 권순용 (가톨릭대학교 의과대학 정형외과학교실)
  • Published : 2009.09.30

Abstract

A deep infection after total hip arthroplasty is a very severe complication that occurs in about 1-2% of the patients. The major cause of this infection is Staphylococcus aureus in the early stage and Staphylococcus epidermidis in the late stage A nontraumatic gas-forming infection is rare and difficult to diagnose because of its slower clinical course than that of gas gangrene. Therefore, it has a high mortality rate due to delayed treatment. There have been no reports on gas-forming infection by Escherichia coli after total hip arthroplasty. We report here on a patient who was treated by open arthrotomy and the patient expired due to a Escherichia coli, gas-forming infection after undergoing total hip arthroplasty.

인공 고관절 치환술 후 발생한 심부 감염은 매우 심각한 합병증으로 약 1~2%에서 발생하며 초기에는 황색 포도상 구균에 의한 감염증, 후기에는 표피 포도상 구균에 의한 감염증이 대부분이다. 그러나, 비외상성 가스 형성 감염은 매우 드물고, 가스 괴저에 비해 느린 임상 결과를 보여 진단이 어려우며 초기의 치료가 늦어져 높은 사망률을 가진다. 또한 인공 관절 치환술 후 발생한 대장균에 의한 가스 형성 감염은 국내에는 보고된 바가 없다. 저자들은 우측 고관절 전치환술을 받은 환자에서 발생한 대장균에 의한 가스 형성 감염을 개방성 관절 절개술로 치료하였으나 사망했던 증례를 보고하고자 한다.

Keywords

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