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类鼻疽:创伤后继发于颞下和咀嚼间隙感染的不常见诊断。

Melioidosis: an unusual diagnosis for deep temporal and masticatory space infection following trauma.

机构信息

Plastic Surgery, KS Hegde Medical Academy, Mangalore, Karnataka, India.

Oral & Maxillofacial Surgery, AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India

出版信息

BMJ Case Rep. 2022 Jun 22;15(6):e248866. doi: 10.1136/bcr-2022-248866.

Abstract

We report a patient in his early 70s, with an alleged history of trauma to the right temporal region, following which a swelling developed. A week later, erythematous changes, throbbing pain and occasional fever spikes were noted. A month after the initial trauma, he presented to our institution with necrosed skin over the right temporal region and swelling extending up to the vertex of the skull. The patient was an uncontrolled diabetic and had systemic conditions like chronic obstructive pulmonary disease and chronic kidney disease. A CT scan revealed a collection along the infratemporal space extending into the masticatory space. Routine investigations, blood culture sensitivity, were sent, which revealed the presence of sensitive to ceftazidime and imipenem. Under antibiotic coverage, the treatment was initiated, incision and drainage were done to reduce the bacterial load. However, the patient was lost to underlying systemic conditions and septic shock.

摘要

我们报告了一位 70 岁出头的患者,据称他的右侧颞部曾受过外伤,随后出现肿胀。一周后,出现红斑变化、搏动性疼痛和偶尔的高热峰值。在最初受伤一个月后,他因右侧颞部皮肤坏死和肿胀延伸至头顶而到我们医院就诊。该患者是一名未控制的糖尿病患者,并有慢性阻塞性肺疾病和慢性肾脏病等系统性疾病。CT 扫描显示沿颞下间隙的一处积液延伸到咀嚼肌间隙。常规检查,包括血液培养敏感性检查,结果显示对头孢他啶和亚胺培南敏感。在抗生素覆盖的情况下,开始进行治疗,进行切开引流以降低细菌负荷。然而,由于潜在的系统性疾病和感染性休克,该患者最终死亡。

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本文引用的文献

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Melioidosis: clinical aspects.类鼻疽病:临床方面。
Clin Med (Lond). 2022 Jan;22(1):6-8. doi: 10.7861/clinmed.2022-0014.
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