Durão Carlos, Barros André, Campos Pedro
Trauma and Orthopaedic Department, Hospital Vila Franca de Xira, Portugal; National Institute of Legal Medicine and Forensic Sciences, Portugal.
Trauma and Orthopaedic Department, Hospital Vila Franca de Xira, Portugal.
J Infect Public Health. 2017 Nov-Dec;10(6):886-887. doi: 10.1016/j.jiph.2016.11.002. Epub 2017 Feb 16.
Cutaneous myiasis is the infestation of the skin or mucous membranes by larvae of the order Diptera. Wound myiasis affect the skin with a previous lesion, and it may consume both dead and living tissue. Finger infestation is rarely a cause of death, but it may provoke considerable morbidity. Prompt wound exploration and careful total larvae removal is essential to achieve healing. In the reported case, the patient was presented in an advanced stage of the infestation, with a large area of finger necrosis and amputation, associated with cellulitis extending from the finger's base to the hand. This diagnosis helped uncover a familiar history of severe abuse and neglect. The accurate understanding and management of such injuries are important not only for the orthopaedic treatment but also for the acknowledgment of their social and forensic implications.
皮肤蝇蛆病是双翅目幼虫对皮肤或黏膜的侵袭。创伤性蝇蛆病影响先前有损伤的皮肤,它可能会蚕食死组织和活组织。手指感染很少导致死亡,但可能引发相当严重的发病情况。及时进行伤口探查并仔细彻底清除幼虫对于实现愈合至关重要。在该报告病例中,患者就诊时处于感染的晚期,手指大面积坏死并已截肢,伴有从手指基部延伸至手部的蜂窝织炎。这一诊断有助于发现严重虐待和忽视的家族病史。准确理解和处理此类损伤不仅对于骨科治疗很重要,而且对于认识其社会和法医意义也很重要。