Hahtapornsawan Suteekhanit, Wongwanit Chumpol, Chinsakchai Khamin, Hongku Kiatisak, Sermsathanasawadi Nuttawut, Ruangsetakit Chanean, Mutirangura Pramook
Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Ann Vasc Surg. 2014 Oct;28(7):1797.e1-6. doi: 10.1016/j.avsg.2014.04.020. Epub 2014 Jun 6.
Vascular pythiosis, a vascular infectious disease in hemoglobinopathy patients, caused by Pythium insidiosum, has an endemic area in tropical and subtropical countries. According to literature review, suprainguinal vascular pythiosis leads to 100% of mortality. The authors report a 35-year-old thalassemic patient who presented with a right inflammatory pulsatile groin mass and right limb ischemia. The computerized tomography angiography indicated a false aneurysm at the right external iliac artery and thrombosed entire right leg arteries. The management comprised antifungal agent, immunotherapy, and surgical removal of all infected arteries (high up to the right common iliac artery and above-knee amputation). The patient was found in a good condition at 36 months after the follow-up period.
血管腐霉病是一种血红蛋白病患者的血管感染性疾病，由隐秘腐霉引起，在热带和亚热带国家有地方性流行区域。根据文献综述，腹股沟上血管腐霉病的死亡率为100%。作者报告了一名35岁的地中海贫血患者，该患者出现右侧炎性搏动性腹股沟肿块和右下肢缺血。计算机断层血管造影显示右髂外动脉有假性动脉瘤，整个右腿动脉血栓形成。治疗包括抗真菌药物、免疫疗法以及手术切除所有感染动脉（高位至右髂总动脉并进行膝上截肢）。随访36个月后，患者状况良好。
