臨床整形外科57巻3号

2022年03月発行

特集 診断・治療に難渋したPeriprosthetic Joint Infectionへの対応 診断編

培養陰性PJIへの対応

著者： 小林直実¹

所属機関： ¹横浜市立大学附属市民総合医療センター整形外科

ページ範囲：P.229 - P.232

人工関節周囲感染(PJI)の診断の基本は細菌培養であり，確定診断と治療選択(抗菌薬選択)に直接関与する最重要検査である．ところが，実際には培養結果が陰性を呈するPJI症例にしばしば遭遇する．このような症例ではPJIの確定診断自体がまず困難となり，抗菌薬選択の根拠が失われ治療に難渋する大きな要因となる．このような問題に対応するには細菌培養法の再考，培養陰性リスク因子についての検討，培養陽性率を上げるための工夫，補助的診断としてのPCR法や核医学画像診断の役割などが重要となる．

参考文献

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