Song Kyle R, Wong Michael S, Yeung Cecilia
Department of Surgery, University of California Davis, Sacramento, California, USA.
Ann Plast Surg. 2008 Apr;60(4):433-6. doi: 10.1097/SAP.0b013e3181238df2.
We report a case of primary cutaneous zygomycosis caused by Rhizopus species in an infant with a hematological malignancy. Multiple surgical debridements, skin grafting, and intravenous antifungal therapy were necessary to ultimately eradicate the infection. Zygomycotic infections are an emerging concern in immunocompromised patients because of their increased incidence as well as their potential to cause substantial morbidity through both emotional distress and impaired functionality. Because resection is a cornerstone of treatment for zygomycosis, the authors anticipate a growing need for plastic surgery involvement for both surgical debridement with limb and tissue-sparing procedures, and for reconstructive options that effectively treat the disease while preserving both function and esthetics. The plastic surgery literature is reviewed regarding surgical and reconstructive options for this population of patients. This case demonstrates the important role plastic surgeons play in the multidisciplinary treatment of zygomycotic and other opportunistic cutaneous infections.
我们报告了一例由根霉属物种引起的原发性皮肤接合菌病，该病例发生在一名患有血液系统恶性肿瘤的婴儿身上。为最终根除感染，需要多次手术清创、皮肤移植和静脉内抗真菌治疗。接合菌感染在免疫功能低下的患者中日益受到关注，这是因为其发病率增加，以及有可能通过情绪困扰和功能受损导致严重发病。由于手术切除是接合菌病治疗的基石，作者预计，对于肢体和组织保留手术的手术清创以及有效治疗疾病同时保留功能和美观的重建选择，整形外科参与的需求将不断增加。本文回顾了整形外科文献中针对这类患者的手术和重建选择。该病例证明了整形外科医生在接合菌病和其他机会性皮肤感染的多学科治疗中所起的重要作用。
