Pascual J, Liaño F, Rivera M, Carrillo R, Ortuño J
Department of Nephrology, Hospital Ramón y Cajal, Madrid, Spain.
Nephron. 1990;55(3):329-31. doi: 10.1159/000185985.
We describe a fatal case of spontaneous necrotizing myositis due to a highly resistant strain of Serratia marcescens in a renal transplant recipient. Though Staphylococcus aureus and Clostridium are the usual agents which cause either pyomyositis or necrotizing myositis, gram-negative bacteria are a dangerous and rarely suspected possibility. Such an aggressive disease should be promptly recognized because immunosuppression in susceptible hosts makes conservative management unsuccessful. The prognosis for myositis in immunodepressed hosts is poor and wide excision of all the necrotic muscles, leaving the wound open, and intensive antibiotic therapy are required.
我们描述了一例肾移植受者因高耐药性粘质沙雷氏菌菌株导致的自发性坏死性肌炎致死病例。虽然金黄色葡萄球菌和梭状芽胞杆菌是引起脓性肌炎或坏死性肌炎的常见病原体，但革兰氏阴性菌也是一种危险且很少被怀疑的可能性。这种侵袭性疾病应及时被识别，因为易感宿主的免疫抑制会使保守治疗失败。免疫抑制宿主中肌炎的预后很差，需要广泛切除所有坏死肌肉，伤口敞开，并进行强化抗生素治疗。
