Wilson C B, Siber G R, O'Brien T F, Morgan A P
Arch Surg. 1976 May;111(5):532-8. doi: 10.1001/archsurg.1976.01360230032005.
Progressive gangrenous cellulitis due to Rhizopus arrhizus following colostomy destroyed the entire abdominal wall of a young woman and caused her death. A similar infection in an 11-year-old kidney transplant recipient was diagnosed more promptly and treated successfully with extensive debridement and amphotericin B. Nine similar cases found in the literature were reviewed. All 11 patients appeared to have had prior tissue injury at the original site of infection, and seven had diabetes mellitus. The disease was initially misdiagnosed in most of the patients, progressed rapidly in eight, and was fatal in four. Phycomycotic gangrenous cellulitis should be included in the differential diagnosis of progressive necrotizing lesions of the skin, especially in diabetic patients, but it can be identified promptly only by histologic examination of the infected tissue. Urgent radical excision and amphotericin therapy are recommended.
根霉引起的进行性坏疽性蜂窝织炎在结肠造口术后破坏了一名年轻女性的整个腹壁并导致其死亡。一名11岁的肾移植受者发生的类似感染诊断更为及时，通过广泛清创和两性霉素B治疗成功。对文献中发现的9例类似病例进行了回顾。所有11例患者在感染的原始部位似乎都有先前的组织损伤，7例患有糖尿病。大多数患者疾病最初被误诊，8例进展迅速，4例死亡。毛霉病性坏疽性蜂窝织炎应列入皮肤进行性坏死性病变的鉴别诊断中，尤其是糖尿病患者，但只有通过对感染组织进行组织学检查才能迅速识别。建议紧急进行根治性切除和两性霉素治疗。
