Tsai Moan-Shane, You Huey-Ling, Tang Ya-Fen, Liu Jien-Wei
Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta-Pei Rd, Niao Sung Hsiang, Kaohsiung Hsien 833, Taiwan.
Int J Infect Dis. 2008 Nov;12(6):e119-24. doi: 10.1016/j.ijid.2008.03.020. Epub 2008 Jun 18.
To better understand the clinical characteristics of soft tissue infections caused by Shewanella in humans.
We report a case of Shewanella soft tissue infection and review the English literature from a search of PubMed.
A total of 27 adults (mean age 61.1+/-16.0 years) with soft tissue infections caused by Shewanella were included for analysis. Limb involvement was found in 22 (81.5%) patients, while scalp, face, perineum, lacrimal sac, and abdominal wall involvement were each found in one patient. Chronic ulcer over the leg (14 cases (51.9%)), steroid use (four cases (14.8%)), and liver cirrhosis (three cases (11.1%)) were the major underlying conditions. Shewanella bacteremia was found in 14 out of 22 patients with soft tissue infections involving the limbs. Two patients died of septicemia, giving a mortality rate of 7.4%.
Shewanella soft tissue infections usually develop in immunocompromised patients with a preexisting cutaneous ulcer (particularly over the legs) after marine environment or seawater exposure. In view of the possible catastrophic consequences, education on the prevention of Shewanella soft tissue infections in at-risk people (e.g., the immunocompromised or elderly with a cutaneous ulcer) relating the need to avoid exposure to the marine environment or seawater may be of importance.
更好地了解希瓦氏菌引起的人类软组织感染的临床特征。
我们报告一例希瓦氏菌软组织感染病例，并通过检索PubMed对英文文献进行综述。
共纳入27例由希瓦氏菌引起软组织感染的成年人（平均年龄61.1±16.0岁）进行分析。22例（81.5%）患者累及肢体，而头皮、面部、会阴、泪囊和腹壁感染各1例。腿部慢性溃疡（14例（51.9%））、使用类固醇（4例（14.8%））和肝硬化（3例（11.1%））是主要的基础疾病。22例累及肢体的软组织感染患者中，14例血培养发现希瓦氏菌。2例患者死于败血症，死亡率为7.4%。
希瓦氏菌软组织感染通常发生在免疫功能低下且先前存在皮肤溃疡（尤其是腿部）的患者中，这些患者在接触海洋环境或海水后发病。鉴于可能产生的灾难性后果，对高危人群（如免疫功能低下者或患有皮肤溃疡的老年人）进行关于预防希瓦氏菌软组织感染的教育，告知其避免接触海洋环境或海水可能很重要。
