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被蜈蚣咬伤后出现不寻常的两阶段感染。

An unusual two-stage infection following a scolopendra bite.

机构信息

Orthopaedic and Trauma Department, Hospital Santa Maria delle Croci, Ravenna, Italy.

Santa Maria della Croci Hospital - Ravenna.

出版信息

Acta Biomed. 2020 Dec 30;91(14-S):e2020009. doi: 10.23750/abm.v91i14-S.10783.

Abstract

BACKGROUND

Scolopendrae represent the best-known genus of centipedes. They are nocturnal general feeders with strong mandibles and venomous fangs which leave visible puncture marks at the bite site. The bite accidents occur during the warm rainy season and mostly take place on the extremities. Following the bite, the most common symptoms are mild: limited localized erythema, pain, swelling, local itching and burning sensation. However, more severe local and systemic sequelae can not be excluded.

METHOD

we report the case of a 63-year-old man with fever and a widespread edema of the right hand and forearm, happened as a consequence of a Scolopendra Subspinipes bite. During the weeks following the bite, he developed a severe unusual superinfection via hematogenous dissemination, which  required a double surgical debridement and a targeted intravenous antibiotic therapy.

RESULTS

the complete clinical recovery took over two month.

CONCLUSIONS

Many victims of Scolopendra envenomation do not seek medical attention since most symptoms will resolve spontaneously. The case presented falls within the spectrum of those rare cases which escalate due to bacterial superinfection.

摘要

背景

蜈蚣是最知名的蜈蚣属。它们是夜行性的杂食动物,具有强壮的颚和有毒的獠牙,在咬伤部位留下明显的穿刺痕迹。咬伤事故发生在温暖的雨季,主要发生在四肢。咬伤后,最常见的症状是轻微的:局限性红斑、疼痛、肿胀、局部瘙痒和烧灼感。然而,不能排除更严重的局部和全身后遗症。

方法

我们报告了一例 63 岁男性的病例,他因被蜈蚣咬伤而发烧,并出现右手和前臂广泛水肿。在咬伤后的几周内,他通过血源性传播发生了严重的不寻常的继发感染,需要进行双次清创和靶向静脉抗生素治疗。

结果

完全临床康复超过两个月。

结论

许多蜈蚣咬伤的受害者没有寻求医疗救治,因为大多数症状会自行缓解。所报告的病例属于那些因细菌继发感染而恶化的罕见病例之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe2f/7944685/f629715f5e1f/ACTA-91-09-g001.jpg

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