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创伤弧菌所致暴发性坏死性筋膜炎。

Fulminant necrotizing fasciitis due to Vibrio parahaemolyticus.

机构信息

Section of Microbiology, University Hospital of Guadalajara, Guadalajara, Spain.

Service of Geriatrics, University Hospital of Guadalajara, Guadalajara, Spain.

出版信息

J Med Microbiol. 2010 Feb;59(Pt 2):235-238. doi: 10.1099/jmm.0.014654-0. Epub 2009 Oct 1.

Abstract

Necrotizing soft-tissue infection due to Vibrio parahaemolyticus is unusual. We report a case of necrotizing fasciitis due to V. parahaemolyticus in a 92-year-old woman with a history of chronic renal failure, diabetes mellitus and malnutrition. Clinical evolution was fulminant and the patient died 6 h after admission. A review of all cases previously reported showed that the infection occurred in patients with underlying diseases through ingestion of raw oysters or inoculation via traumatic injury in marine environments. The mortality rate of all reviewed cases was 42.8 %. In conclusion, V. parahaemolyticus should be considered a possible causative agent of necrotizing fasciitis, especially in patients with underlying disease. Early diagnosis and prompt aggressive debridement associated with antibiotic therapy are essential in order to save the patient's life, because clinical evolution can be fulminant and mortality rates are high.

摘要

副溶血弧菌引起的坏死性软组织感染并不常见。我们报告了一例 92 岁老年女性坏死性筋膜炎病例,该患者有慢性肾衰竭、糖尿病和营养不良病史。临床病程迅速恶化,患者入院后 6 小时死亡。对所有既往报告的病例进行回顾,感染发生在有基础疾病的患者中,通过摄入生牡蛎或在海洋环境中通过创伤接种。所有回顾病例的死亡率为 42.8%。总之,副溶血弧菌应被视为坏死性筋膜炎的一个可能病原体,尤其是在有基础疾病的患者中。早期诊断和及时积极的清创术联合抗生素治疗对于挽救患者生命至关重要,因为临床病程可能迅速恶化,死亡率较高。

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