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[并非只有用培根才能捕鼠。皮肤蝇蛆病的无创治疗方法]

[One catches not only mice with bacon. An atraumatic treatment for cutaneous myiasis].

作者信息

Schulte C, Schunk M, Krebs B

机构信息

Abteilung für Infektions- und Tropenmedizin, Medizinische Klinik Innenstadt der Ludwig-Maximilians-Universität München, Germany.

出版信息

Dtsch Med Wochenschr. 2002 Feb 8;127(6):266-8. doi: 10.1055/s-2002-19969.

Abstract

HISTORY AND ADMISSION FINDINGS

A 37 year old patient was admitted because of four prurigous furunculoid swellings on his right upper knee. The patient had a history of traveling in Brasil for 6 weeks, returning 2 weeks before admission. The nodular skin lesions, 2.5 cm in diameter, had a central opening, from where under little pressure a seropurulent fluid discharged. In the central opening moving, whitish structures were visible.

TREATMENT AND COURSE

A piece of raw bacon, serving as occlusion-material, was fixated on the affected skin for two hours. The larvae emerged due to oxygen deficiency. After retraction of the bacon it was possible to grasp the emerged end of the larvae with tweezers and pull them out completely. The larvae were identified as third instar of dermatobia hominis.

CONCLUSION

Cutaneous myiasis is a worthy differential diagnosis in patients presenting with furunculoid skin lesions after traveling to endemic areas. The treatment with bacon as an occlusion-material offers an atraumatic alternative to surgical excision.

摘要

病史及入院检查结果

一名37岁患者因右膝上方出现4个瘙痒性疖样肿胀而入院。患者有在巴西旅行6周的病史,入院前2周回国。结节性皮肤病变直径为2.5厘米,有一个中央开口,在轻微按压下会从中排出浆液脓性液体。在中央开口处可见蠕动的白色结构。

治疗及病程

一片生培根作为封堵材料,固定在患处皮肤两小时。由于缺氧,幼虫出现。取下培根后,可以用镊子抓住幼虫露出的一端并将它们完全拉出。这些幼虫被鉴定为人皮蝇的第三龄幼虫。

结论

皮肤蝇蛆病是前往流行地区后出现疖样皮肤病变患者的一个值得鉴别的诊断。用培根作为封堵材料进行治疗为手术切除提供了一种无创替代方法。

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