Pediatric Infection and Vaccine

  • 제29권3호
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  • Pages.173-178
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  • 2022
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  • 2384-1079(pISSN)
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  • 2384-1087(eISSN)
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)
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특이 과거력이 없는 소아에서 발생한 Streptococcus intermedius 화농 관절염 1예

A Case of Septic Arthritis due to Streptococcus intermedius in a Healthy Child

  • 용수민 (아주대학교 의과대학 아주대학교병원 소아청소년과) ;
  • 김태훈 (아주대학교 의과대학 아주대학교병원 정형외과) ;
  • 정현주 (아주대학교 의과대학 아주대학교병원 소아청소년과)
  • Soo Min Yong (Department of Pediatrics, Ajou University Hospital, Ajou University College of Medicine) ;
  • Tae Hun Kim (Department of Orthopedic Surgery, Ajou University Hospital, Ajou University College of Medicine) ;
  • Hyun Joo Jung (Department of Pediatrics, Ajou University Hospital, Ajou University College of Medicine)
  • 투고 : 2022.09.26
  • 심사 : 2022.12.15
  • 발행 : 2022.12.25
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초록

Streptococcus intermedius는 입안, 상부 호흡기, 위장관 등에 정상 상재균 중 하나로 존재하는 그람 양성 산소내성 혐기성 알균이다. 면역저하나 심장질환자에서 외상 또는 침습적 치료 후에 발생하는 기회 감염의 원인이 될 수 있다. 저자들은 최근 침습적 치료나 외상 등 특이 과거력이 없이 건강했던 7세 소아에서 S. intermedius에 의해 발생한 엉덩관절 화농 관절염을 경험하였기에 보고하고자 한다. 환자는 내원 3주전부터 왼쪽 엉덩관절 통증이 있었으며, 본원 내원 당일부터 발열이 발생하였다. 엉덩관절 자기공명영상에서 왼쪽 엉덩관절의 급성 화농 관절염으로 진단한 후 수술적 배농을 시행하였고, 혈액과 흡인 관절액에서 S. intermedius가 배양되었다. 수술 후 2주간의 ceftriaxone 정맥주사 후 3주간의 amoxicillin 경구 항생제로 치료한 후 재발없이 안정된 상태를 보이고 있다.

Streptococcus intermedius is a small, non-motile, Gram-positive, non-sporeforming, and aerotolerant anaerobic coccus. It is a part of the normal microflora in the oral cavity and upper respiratory, gastrointestinal and female urogenital tracts. It is an opportunistic pathogen that causes serious infections in patients with immunocompromised states or cardiac diseases as a result of trauma or invasive procedures. We describe a case of septic arthritis of the hip caused by S. intermedius in an immunocompetent healthy 7-year-old boy without a history of periodontal disease or invasive procedures. He had hip joint pain three weeks ago, and the fever began on the day of the visit. He had been healthy and had not undergone any invasive procedures recently. Septic arthritis of the hip was indicated in the magnetic resonance imaging of the hip. S. intermedius was identified in the hip joint fluid aspiration and blood culture. He was successfully treated with surgical intervention and antibiotic therapy with ceftriaxone followed by amoxicillin for five weeks.

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참고문헌

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