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[皮肤内脏利什曼病:病例报告及治疗进展]

[Viscerocutaneous loxoscelism: case report and update on management].

作者信息

Harz-Fresno Isidora, Manterola Pilar, Ru Z Magdalena, Abud Cristina

出版信息

Rev Chilena Infectol. 2015 Apr;32(2):230-3. doi: 10.4067/S0716-10182015000300014.

Abstract

Loxoscelism is a condition produced by the bite of Loxosceles laeta. It can present as cutaneous loxoscelism with only vascular dermal manifestations or as viscerocutaneus loxoscelism with systemic compromise and a mortality rate of 1 to 3%. We report the case of an adult patient presenting viscerocutaneus loxoscelism, who was evolving with macrohematuria, edema, and progressive blisters, requiring treatment in the intensive care unit. He was treated according to the actual scientific evidence with antihistamines, corticosteroids, and dual antibiotic therapy covering Streptococcus spp., Staphylococcus spp., and anaerobes, particularly penicillin and tetracycline resistant C. perfringens. The use of dapsone and antiloxosceles-serum was avoided. The patient showed a favorable clinical evolution.

摘要

褐蛛中毒是由巴西游走蛛叮咬引起的一种病症。它可表现为仅具有血管性皮肤表现的皮肤型褐蛛中毒,或伴有全身损害且死亡率为1%至3%的皮肤内脏型褐蛛中毒。我们报告了一例出现皮肤内脏型褐蛛中毒的成年患者,该患者伴有肉眼血尿、水肿和进行性水疱,需要在重症监护病房接受治疗。我们根据实际科学证据,用抗组胺药、皮质类固醇以及覆盖链球菌属、葡萄球菌属和厌氧菌(特别是对青霉素和四环素耐药的产气荚膜梭菌)的双重抗生素疗法对其进行治疗。避免使用氨苯砜和抗褐蛛血清。该患者临床病情呈良好进展。

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