膀胱腫瘍手術後に診断困難であったMRSA性右股関節炎症

A Case of MRSA Bone Infection Difficult to Distinguish from Bone Metastasis FolloWing Radical Operation of Bladder Cancer

　膀胱癌の診断で膀胱全摘除術後にMRSAによる骨感染症を来した症例を報告する。膀胱全摘除術後MRSAの敗血症を来しVCMによる治療ののち全身状態は改善したが，股関節痛や持続的なCRP上昇を認めた。骨シンチで右股関節，肋骨などに集積の亢進を認め，多発性骨転移が疑われた。数か月後，集積の亢進は肋骨その他の部位で改善したため，骨，関節感染症が疑われた。股関節穿刺培養でMRSA感染症と診断された。

We describe a 67 year-old-woman with bladder carcinomawho developed MRSA joint and bone infection followingradical cystectomy. She had continuous fever, high levelCRP and hip joint pain for a few months. Bone scan showedincreased uptake in the right hip joint, ribs, breast boneand clavicula, and multiple bone metastasis was suspected.A few months later, however, hot spots at ribs disappearedand other hot spot were improved Without further therapy.The pus was aspirated and MRSA was detected in the hipjoint fluid.