Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
Int Wound J. 2017 Oct;14(5):818-822. doi: 10.1111/iwj.12711. Epub 2017 Jan 4.
Vibrio vulnificus can cause severe skin and soft tissue infection (SSTI). The pathogen is an opportunistic marine bacterium that is likely to infect patients with chronic liver disease, patients in an immunocompromised state, and those in end-stage renal disease. V. vulnificus gains entry through soft tissues by direct penetration of a wound by infected marine organisms, such as raw oysters, shellfish and other seafood, or by exposing a wound to contaminated water. Despite its ease of entry, V. vulnificus necrotising fasciitis with compartment syndrome has rarely been described. We report a case of an elderly patient with end-stage renal disease undergoing haemodialysis, who developed necrotising fasciitis following infection by V. vulnificus through a puncture injury while cleaning fish. A successful salvage and reconstruction surgery was performed using fenestrated-type artificial dermis followed by negative pressure wound therapy. This case presents a reasonable treatment option for threatening V. vulnificus necrotising fasciitis with compartment syndrome.
创伤弧菌可引起严重的皮肤和软组织感染(SSTI)。病原体是一种机会性海洋细菌,可能感染慢性肝病患者、免疫功能低下患者和终末期肾病患者。创伤弧菌通过受感染的海洋生物(如生蚝、贝类和其他海鲜)直接穿透伤口,或通过使伤口暴露于受污染的水中,从而进入软组织。尽管创伤弧菌容易进入,但伴有筋膜间室综合征的坏死性筋膜炎很少见。我们报告了一例老年终末期肾病血液透析患者,在清洗鱼类时,穿刺伤感染创伤弧菌后发生坏死性筋膜炎。采用开窗型人工真皮联合负压创面治疗成功进行了挽救性重建手术。该病例为伴有筋膜间室综合征的威胁性创伤弧菌坏死性筋膜炎提供了一种合理的治疗选择。