Jones Neil F, Shin Eon K, Eo SuRak, Starzl Thomas E
University of California Irvine Hand Center, 101 The City Drive South, Pavilion III, Orange, CA 92868, USA.
Hand (N Y). 2008 Dec;3(4):332-6. doi: 10.1007/s11552-008-9119-x. Epub 2008 Aug 6.
A 6-month-old child developed cutaneous mucormycosis of the forearm 5 weeks after liver transplantation, which progressed to osteomyelitis of the proximal ulna. Aggressive treatment, which included serial radical debridements, intravenous administration of amphotericin B, and eventually split thickness skin graft coverage resulted in successful functional salvage of the forearm, wrist, and hand. Of the nine previously reported cases of mucormycosis affecting the forearm or hand in immunocompromised patients, all either required amputation of the hand or below elbow amputation, or resulted in the patient's death. Definitive early diagnosis and serial radical debridements may allow salvage of a functional hand.
一名6个月大的儿童在肝移植后5周出现前臂皮肤毛霉菌病,并进展为尺骨近端骨髓炎。积极的治疗措施包括多次根治性清创、静脉注射两性霉素B,最终采用中厚皮片移植覆盖,成功挽救了前臂、手腕和手部的功能。在先前报道的9例免疫功能低下患者中发生的影响前臂或手部的毛霉菌病病例中,所有患者均需进行手部截肢或肘部以下截肢,或导致患者死亡。早期明确诊断和多次根治性清创可能有助于挽救手部功能。