Yoshihara Hanako, Kurihara Ibuki, Hori Hiroshi, Fukuchi Takahiko, Sugawara Hitoshi
Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical Center, Jichi Medical University, Saitama, JPN.
Department of Internal Medicine, Minamiuonuma City Hospital, Niigata, JPN.
Cureus. 2022 Apr 28;14(4):e24573. doi: 10.7759/cureus.24573. eCollection 2022 Apr.
Cases of subcutaneous abscess due to () infection are rare, even among immunocompromised patients. To our knowledge, there have only been eleven reports of such cases in adults, all of which presented with comorbidities of immunodeficiency, prior antibiotic administration, or skin breakdown following traumatic episodes or iatrogenic procedures. We report a rare case of a 42-year-old Japanese woman with a subcutaneous abscess due to infection. The patient was referred to our hospital with a chief complaint of gradually worsening lower left-sided chest pain. Nine months before admission, she underwent laparoscopic cholecystectomy (Lap-C) for acute cholecystitis at another hospital. She developed fever and was treated with cefotiam for three days followed by cefoperazone/sulbactam for four days. One week after Lap-C, she began to feel pain in the lower left side of her chest. The chest pain worsened gradually and the fever persisted until two months before admission. On admission, enhanced chest computed tomography revealed a left chest subcutaneous abscess located between the seventh and ninth rib. She underwent surgical percutaneous drainage, and the abscess cavity was cleaned. The pus culture revealed , but the blood cultures were negative. We administered intravenous micafungin (150 mg daily) for 10 days, followed by oral fluconazole (600 mg daily). She experienced telogen effluvium during the period of fluconazole treatment but recovered after the cessation of fluconazole. We also present a short review of the literature relating to subcutaneous candidal abscesses in patients over 15 years old.
由（）感染引起的皮下脓肿病例罕见，即便在免疫功能低下的患者中亦是如此。据我们所知，成人中仅有11例此类病例报告，所有病例均伴有免疫缺陷、先前使用抗生素、创伤性事件或医源性操作后皮肤破损等合并症。我们报告一例罕见的42岁日本女性因（）感染出现皮下脓肿的病例。该患者因左下胸部疼痛逐渐加重为主诉被转诊至我院。入院前9个月，她在另一家医院因急性胆囊炎接受了腹腔镜胆囊切除术（Lap - C）。她出现发热，先用头孢替安治疗3天，后用头孢哌酮/舒巴坦治疗4天。Lap - C术后1周，她开始感到左下胸部疼痛。胸痛逐渐加重，发热持续至入院前2个月。入院时，胸部增强计算机断层扫描显示左侧胸部皮下脓肿位于第7和第9肋骨之间。她接受了经皮手术引流，并清理了脓肿腔。脓液培养显示（），但血培养阴性。我们静脉注射米卡芬净（每日150毫克）10天，随后口服氟康唑（每日600毫克）。在氟康唑治疗期间她出现了休止期脱发，但氟康唑停药后恢复。我们还对15岁以上患者皮下念珠菌脓肿的相关文献进行了简要综述。
