Bernardes Teresa, Ostilla Lorena, Fazal Amara, Nasseri-Nik Niloofar, Otrakji Christian, Haddad Ghassan, Murillo Jorge
Department of Medicine, South Miami Hospital, Baptist Health of South Florida, Miami, USA.
Department of Pathology, South Miami Hospital, Baptist Health of South Florida, Miami, USA.
Cureus. 2022 Jan 11;14(1):e21111. doi: 10.7759/cureus.21111. eCollection 2022 Jan.
Soft tissue infection is an uncommon presentation of in the absence of immunosuppression. Most infected patients present with pneumonia or meningitis, often with signs of disseminated disease, which may be fatal. We present a case of an 81-year-old mildly immunocompromised woman with multiple comorbidities, who presented with an extensive soft tissue infection on her right medial thigh. Superficial skin culture grew vancomycin-resistant ; however, both initial and subsequent antibacterial therapies failed to resolve the infection. Subsequent biopsy revealed abundant yeasts, and mucicarmine staining confirmed infection in a patient with no evidence of disseminated disease. Wound debridement and fluconazole for six months resulted in complete resolution of the lesion. In this report, we emphasize the need for tissue biopsy and microbial cultures in diagnosing patients with atypical skin and soft tissue infections who do not respond to appropriate antibiotics.
在没有免疫抑制的情况下，软组织感染是一种不常见的表现形式。大多数感染患者表现为肺炎或脑膜炎，常伴有播散性疾病的体征，这可能是致命的。我们报告一例81岁轻度免疫功能低下且患有多种合并症的女性病例，她右侧大腿内侧出现广泛的软组织感染。浅表皮肤培养出耐万古霉素的[具体病菌名称未给出]；然而，初始及后续的抗菌治疗均未能解决感染问题。随后的活检发现大量酵母菌，黏液卡红染色证实该患者存在感染，且无播散性疾病的证据。伤口清创及使用氟康唑治疗六个月后，病变完全消退。在本报告中，我们强调对于对适当抗生素无反应的非典型皮肤和软组织感染患者，进行组织活检和微生物培养以进行诊断的必要性。
