Sebastian Albertina, Sebastian Natasha, Arulthasan Marutha, Simon Ronald, Nicastro Jeffrey M
Surgery, Maimonides Medical Center, Brooklyn, USA.
Infectious Disease, Maimonides Medical Center, Brooklyn, USA.
Cureus. 2023 Apr 8;15(4):e37314. doi: 10.7759/cureus.37314. eCollection 2023 Apr.
A 53-year-old male with active IV heroin use presented with left upper extremity pain, erythema, swelling, and purulent foul-smelling drainage. Rapid diagnosis of necrotizing soft tissue infection (NSTI) was made based on clinical and radiologic findings. He was taken to the operating room for wound washouts and surgical debridements. The early microbiologic diagnosis was made based on intraoperative cultures. Successful treatment of NSTI in the setting of rare pathogens was achieved. The wound was ultimately treated with wound vac therapy, followed by primary delayed closure of the upper extremity and skin grafting of the forearm. We present a case of NSTI secondary to Streptococcus constellatus, Actinomyces odontolyticus, and Gemella morbillorum in an intravenous (IV) drug user, successfully treated with early surgical intervention.
一名53岁有静脉注射海洛因史的男性，出现左上肢疼痛、红斑、肿胀及有恶臭的脓性引流物。根据临床和影像学检查结果迅速诊断为坏死性软组织感染（NSTI）。他被送往手术室进行伤口冲洗和外科清创术。术中培养结果做出了早期微生物学诊断。在罕见病原体感染的情况下，NSTI得到了成功治疗。伤口最终采用伤口负压治疗，随后对上肢进行一期延迟缝合和前臂皮肤移植。我们报告一例因星座链球菌、溶齿放线菌和麻疹孪生球菌导致的NSTI病例，该静脉注射毒品使用者通过早期手术干预获得成功治疗。
