Talbot Zuzana, Amble Arun, Delva Guesly, Eddib Abdulmagid, Muddassir Salman
Internal Medicine, Oak Hill Hospital, Brooksville, USA.
Internal Medicine, Oak Hill Hospital, Brookville, USA.
Cureus. 2019 Sep 16;11(9):e5668. doi: 10.7759/cureus.5668.
A 69-year-old woman with type 2 diabetes mellitus, peripheral vascular disease, and other comorbidities presented with recurrent syncopal episodes. Cellulitic skin changes in her right lower extremity were noted, as well as a large hemorrhagic bulla on the dorsum of her right foot. Severe sepsis was determined to be the reason for her syncopal episodes. Blood cultures and the bulla aspirate culture were positive for Shewanella algae that was pan-sensitive to antibiotics. Her clinical status was stabilized with a regimen of intravenous fluids and broad-spectrum antibiotics. However, due to the development of right foot gangrene, she underwent debridement and eventually required transmetatarsal open amputation.
一名69岁患有2型糖尿病、外周血管疾病及其他合并症的女性出现反复发作的晕厥。右下肢可见蜂窝织炎样皮肤改变，右足背有一个大的出血性水疱。确定严重脓毒症是其晕厥发作的原因。血培养和水疱抽吸物培养显示海藻希瓦氏菌阳性，该菌对多种抗生素敏感。通过静脉补液和广谱抗生素治疗，她的临床状况得以稳定。然而，由于右足坏疽的发展，她接受了清创术，最终需要行经跖骨开放性截肢术。
