布鲁氏菌病仍然是全世界流行地区的广泛疾病,没有得到充分控制。它是世界范围内常见的人畜共患疾病,全身性感染,和流行国家的主要健康问题。由于布鲁氏菌病导致的股骨头缺血性坏死(FHAVN)非常罕见,很少有记录。该病例报告一名21岁女性患者因双下肢剧烈疼痛住院,特别是在髋关节的前部,伴有持续六个月的低烧。右髋部运动疼痛,走了几步后,病人一开始就一瘸一拐地走了。类风湿因子和抗核抗体检测结果均为阴性。右髋关节被抽吸,并送少量液体进行革兰氏染色和培养。滑膜关节液培养4周后证实流产布鲁氏菌感染。本案的感染源是食用生牛奶。根据实验室测试和射线照相图像,FHAVN被诊断。由于误诊,在过去的几个月里,她没有接受过布鲁氏菌病的标准治疗。病人被早期诊断出来,她在第三阶段。患者接受治疗后,左右髋关节部分恢复。右髋关节需要置换;然而,病人拒绝了。主治医师应考虑将布鲁氏菌病作为关节炎的替代方法,以治疗布鲁氏杆菌流行地区的髋关节疼痛。药物治疗可能对早期缺血性坏死有效,强调早期诊断和治疗的必要性。
Brucellosis remains a widespread disease in endemic regions worldwide and is not adequately controlled. It is a common zoonotic disease worldwide, a systemic infection, and a major health problem in endemic countries. Femoral head avascular necrosis (FHAVN) as a consequence of brucellosis is exceedingly unusual and has seldom been recorded. The
case reports a 21-year-old female patient was hospitalized due to severe pain in both lower limbs, particularly in the anterior portion of the hip joint, accompanied by a low-grade fever persisting for six months. Movement of the right hip was painful, and the patient limped at the beginning of walking after a few steps. Rheumatoid factor and antinuclear antibody test results were negative. The right hip joint was aspirated, and a small quantity of fluid was sent for Gram staining and culture. Synovial joint fluid culture confirmed Brucella abortus infection after four weeks. The source of infection in the present
case was the consumption of raw milk. Based on laboratory tests and radiographic images, FHAVN was diagnosed. Owing to misdiagnosis, she had not received standard treatment for brucellosis in the previous months. The patient was diagnosed early, and she was in the third stage. After the patient received medical treatment, the left and right hip joints partly recovered. The right hip joint required replacement; however, the patient refused. Attending physicians should consider brucellosis as an alternative to arthritis for hip joint pain in Brucella-endemic locations. Medication-based therapy may be effective for early avascular necrosis, emphasizing the need for early diagnosis and treatment.