Chen Hsin-Han, Shih Pin-Keng
Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung.
China Medical University, Taichung.
SAGE Open Med Case Rep. 2019 Apr 9;7:2050313X19841963. doi: 10.1177/2050313X19841963. eCollection 2019.
species, a soil-borne fungi, causes disease in animals and humans, particularly in immunocompromized patients. A 62-year-old male presented with type II diabetes mellitus, diagnosed 4 years ago. He had a motorcycle accident-caused open tibiofibular fracture of the left lower extremity (Gustilo grade IIIb). With open reduction and internal fixation, an anterolateral thigh musculocutaneous flap was harvested for coverage of exposed bone and defect reconstruction. Partial failure of the flap occurred 9 days following reconstruction, and histological examination revealed spp. After treatment with antifungal drugs and debridement, we performed a split-thickness skin graft. At 2-year follow-up, the flap was viable with adequate bone union. This is the first reported case of partial flap failure due to a spp. infection. Possibility of fungal infections in patients with late-onset flap failure should be noted. Prompt diagnosis and treatment are needed to prevent repeated free-tissue transfer and/or devastating outcomes.
某物种，一种土壤传播的真菌，可导致动物和人类患病，尤其是免疫功能低下的患者。一名62岁男性，4年前被诊断为II型糖尿病。他曾因摩托车事故导致左下肢开放性胫腓骨骨折（ Gustilo IIIb级）。在进行切开复位内固定后，切取了股前外侧肌皮瓣用于覆盖外露骨质和缺损重建。重建后9天皮瓣部分坏死，组织学检查发现了该物种。在用抗真菌药物治疗和清创后，我们进行了中厚皮片移植。在2年的随访中，皮瓣存活，骨愈合良好。这是首例报道的因该物种感染导致皮瓣部分坏死的病例。应注意迟发性皮瓣坏死患者发生真菌感染的可能性。需要及时诊断和治疗以防止再次进行游离组织移植和/或出现严重后果。
