medicina61巻9号

2024年08月発行

特集 リウマチ膠原病疾患Up To Date！—押さえておきたい最新の診断と治療 リウマチ膠原病疾患と鑑別すべき疾患の診断と治療

感染性関節炎の診断と治療

著者： 嶋崎鉄兵¹

所属機関： ¹杏林大学医学部臨床感染症学教室

ページ範囲：P.1450 - P.1454

Point
◎急性単関節炎では，化膿性関節炎の可能性を検討する．関節穿刺液での結晶の存在は，感染の可能性を必ずしも否定しない．
◎人工関節感染（PJI）では，関節穿刺液の評価基準が異なる点を理解する．
◎化膿性滑液包炎の疫学，診断を理解する．
◎関節痛は多くの感染性疾患に伴って生じるが，急性期に治療方針が変わる例は限られる．

参考文献

1）Guidelines for the initial evaluation of the adult patient with acute musculoskeletal symptoms. American College of Rheumatology Ad Hoc Committee on clinical guidelines. Arthritis Rheum 39：1-8, 1996 PMID 8546717

2）Foster ZJ, et al：Polyarticular joint pain in adults；Evaluation and differential diagnosis. Am Fam Physician 107：42-51, 2023 PMID 36689970

3）Miller JM, et al：A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases；2018 update by The Infectious Diseases Society of America and The American Society for Microbiology. Clin Infect Dis 67：e1-e94, 2018 PMID 29955859

4）Shah K, et al：Does the presence of crystal arthritis rule out septic arthritis? J Emerg Med 32：23-26, 2007 PMID 17239729

5）Nelson GE, et al：Epidemiology of invasive group A Streptococcal Infections in the United States, 2005-2012. Clin Infect Dis 63：478-486, 2016 PMID 27105747

6）Hunter JG, et al：Risk factors for failure of a single surgical debridement in adults with acute septic arthritis. J Bone Joint Surg Am 97：558-564, 2015 PMID 25834080

7）Osmon DR, et al；Infectious Diseases Society of America：Diagnosis and management of prosthetic joint infection；Clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 56：e1-e25, 2013 PMID 23223583

8）McNally M, et al：The EBJIS definition of periprosthetic joint infection. Bone Joint J 103-B：18-25, 2021 PMID 33380199

9）Baumbach SF, et al：Prepatellar and olecranon bursitis；Literature review and development of a treatment algorithm. Arch Orthop Trauma Surg 134：359-370, 2014 PMID 24305696

10）Scroggie DA, et al：Parvovirus arthropathy outbreak in southwestern United States. J Rheumatol 27：2444-2448, 2000 PMID 11036842

11）Soni S, et al：Dengue, chikungunya, and zika；The causes and threats of emerging and re-emerging arboviral diseases. Cureus 15：e41717, 2023 PMID 37575782