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一例复发性皮肤脓肿病例:详细询问性病史后谜题得解

A Case of Recurrent Skin Abscesses: A Conundrum Solved after Obtaining a Thorough Sexual History.

作者信息

Peralta Diego P, Chang Aymara Y, Soto-Ruiz Enrique

机构信息

Division of Infectious Diseases, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, TX 79905, USA.

Division of General Internal Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, TX 79905, USA.

出版信息

Case Rep Infect Dis. 2017;2017:4765697. doi: 10.1155/2017/4765697. Epub 2017 Mar 13.

DOI:10.1155/2017/4765697
PMID:28386492
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5366776/
Abstract

. Despite the improvement in patient-physician communication techniques, sexuality and sexual health continue to be challenging areas for discussion during a clinical encounter. Most people are not prepared to discuss sexual matters openly as it can be perceived as negative or inappropriate. Consequently, an incomplete health assessment can result in delayed diagnosis or misdiagnosis. . We present a 33-year-old woman who developed recurrent left breast abscesses. She required multiple incision and drainage procedures in the operating room followed by antimicrobial therapy. Although she always had an initial improvement with this approach, she continued to have recurrences and development of new abscesses in other body areas. The polymicrobial nature of her recurrences prompted an extensive and costly workup to determine the nature of her condition. The cause was finally elucidated when a thorough sexual history was obtained. Poor hygiene practices during her sexual encounters were considered the cause of her recurrent abscesses. After medical therapy and modification of her sexual practices, she has not developed new recurrences for more than two years. . Discussions on sexuality and sexual health are important parts of any clinical encounter, yet frequently forgotten or avoided. Becoming aware of their importance would avoid delayed diagnosis or misdiagnosis.

摘要

尽管医患沟通技巧有所改进,但在临床诊疗过程中,性与性健康仍是颇具挑战性的讨论领域。大多数人并不准备公开讨论性问题,因为这可能被视为负面或不合适的。因此,不完整的健康评估可能导致诊断延迟或误诊。

我们介绍一位33岁女性,她反复出现左乳脓肿。她在手术室接受了多次切开引流手术,随后进行抗菌治疗。尽管采用这种方法她最初总会有所好转,但她仍不断复发,且身体其他部位出现新的脓肿。她复发的多重微生物性质促使进行了广泛且昂贵的检查以确定其病情的性质。当获取详尽的性病史后,病因最终得以阐明。她性接触期间不良的卫生习惯被认为是其反复脓肿的原因。经过药物治疗并改变其性行为方式后,她已两年多未出现新的复发情况。

关于性与性健康的讨论是任何临床诊疗的重要组成部分,但却常常被遗忘或回避。意识到其重要性可避免诊断延迟或误诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c55/5366776/205fb2953a61/CRIID2017-4765697.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c55/5366776/205fb2953a61/CRIID2017-4765697.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c55/5366776/205fb2953a61/CRIID2017-4765697.001.jpg

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