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创伤弧菌所致坏死性筋膜炎:接触海洋生物后威胁肢体的皮肤并发症

Necrotising fasciitis with Vibrio vulnificus: a limb threatening dermatologic complication following exposure to marine life.

作者信息

Kushawaha Anurag, Mobarakai Neville, Cooper Michael, Rose Kenneth, Awasum Michael

机构信息

Staten Island University Hospital, Internal Medicine, Staten Island, New York, NY10305, USA.

出版信息

BMJ Case Rep. 2010 May 6;2010:bcr11.2009.2478. doi: 10.1136/bcr.11.2009.2478.

Abstract

Vibrio vulnificus is a rare cause of necrotising fasciitis. The organism can be found in warm, shallow coastal waters, as well as on shellfish, such as crab, and also filter-feeding molluscs, such as oysters, clams, and scallops. In the USA, it is the leading cause of shellfish related deaths. In individuals with major underlying illnesses, such as liver disease, diabetes mellitus, malignancy, alcoholism, haemochromatosis or chronic renal disease, the organism can lead to a fulminant course with a high degree of mortality. Early antimicrobial treatment and timely surgical interventions can be potentially life preserving in serious infections with V vulnificus. We report a case of an elderly patient with end stage renal disease on haemodialysis who developed necrotising fasciitis with V vulnificus following a puncture injury while cleaning crabs.

摘要

创伤弧菌是坏死性筋膜炎的罕见病因。该菌可在温暖的浅海沿岸水域中发现,也存在于贝类(如螃蟹)以及滤食性软体动物(如牡蛎、蛤蜊和扇贝)身上。在美国,它是与贝类相关死亡的主要原因。在患有严重基础疾病(如肝病、糖尿病、恶性肿瘤、酗酒、血色素沉着症或慢性肾病)的个体中,该菌可导致病情迅猛发展,死亡率很高。对于创伤弧菌严重感染,早期抗菌治疗和及时的手术干预可能挽救生命。我们报告一例老年终末期肾病患者,在清洗螃蟹时发生穿刺伤后,感染创伤弧菌并发展为坏死性筋膜炎。

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