Zhu Z K, Weng T T, Wang X G, Zhi L Z, Yu C H, Zhang Z Z, Han C M
Department of Burns, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
Zhonghua Shao Shang Za Zhi. 2019 Aug 20;35(8):619-621. doi: 10.3760/cma.j.issn.1009-2587.2019.08.014.
On January 1st 2018, a male 44 years old diabetic patient with subcutaneous soft tissue infection in right thigh was admitted to our hospital. The patient repeatedly used the same needle to inject insulin subcutaneously in the unsterilized right thigh, and his blood glucose was badly controlled in the long term. Severe subcutaneous soft tissue infection of the right thigh occurred after his fatigue, accompanied with ketoacidosis. Then he received conservative treatment in the local hospital for one month, but the infection persisted. After being transferred to our hospital, we highly suspected the diagnosis of necrotizing fasciitis according to previous test indicators and local B-ultrasound results, but suggestion of aggressive surgery was refused. So we treated him with conservative therapies using sensitive antibiotics and supportive remedies. The patient was basically healed after treatment of 1 month and he was recovered well during the follow-up 2 months after discharged from our hospital. This case emphasizes the importance of standard injection of insulin and early diagnosis of severe subcutaneous soft tissue infection.
2018年1月1日，一名44岁的男性糖尿病患者因右大腿皮下软组织感染入住我院。该患者长期在未消毒的右大腿反复使用同一根针头皮下注射胰岛素，血糖长期控制不佳。在其劳累后出现右大腿严重皮下软组织感染，并伴有酮症酸中毒。随后在当地医院接受了1个月的保守治疗，但感染持续存在。转入我院后，根据既往检查指标及局部B超结果，高度怀疑为坏死性筋膜炎，但患者拒绝积极手术建议。因此，我们采用敏感抗生素及支持疗法进行保守治疗。治疗1个月后患者基本痊愈，出院后随访2个月恢复良好。该病例强调了胰岛素规范注射及严重皮下软组织感染早期诊断的重要性。
