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一名17岁的学生从脚踝扭伤发展到腿部截肢。

A 17-year-old student with ankle sprain to leg amputation.

作者信息

Yang Xi, Ding Yinhuan, Liu Yong, Shi Yixue, Sun Xiaolei

机构信息

Department of General Surgery (Vascular Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.

Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou 646000, Sichuan, China.

出版信息

J Surg Case Rep. 2024 Feb 7;2024(2):rjae003. doi: 10.1093/jscr/rjae003. eCollection 2024 Feb.

Abstract

Cutaneous mucormycosis with ischemic complications is a life-threatening condition with high mortality rates, particularly in immunocompromised individuals. The incidence of mucormycosis has increased during the COVID-19 pandemic due to reduced immunity. We present the case of a 17-year-old high school student who experienced a sprained left lower extremity, followed by worsening pain and swelling due to the topical application of unknown local herbs. Eighteen days after the injury, she was admitted to our department in a comatose state with left lower limb ischemia. The patient had a history of uncontrolled diabetes mellitus and displayed a necrotic lesion on her left ankle, suggestive of invasive infectious fungi disease. Diagnostic procedures, including tissue staining and molecular analysis, identified as the causative organism. Administering amphotericin B yielded marked improvement, but the patient necessitated a mid-thigh amputation to curtail the infection's advance, culminating in her successful discharge post-treatment.

摘要

伴有缺血性并发症的皮肤毛霉病是一种危及生命的疾病,死亡率很高,尤其是在免疫功能低下的个体中。由于免疫力下降,在新冠疫情期间毛霉病的发病率有所增加。我们报告一例17岁的高中生病例,该患者左下肢扭伤,随后因局部涂抹不明草药导致疼痛和肿胀加剧。受伤18天后,她因左下肢缺血昏迷被收入我科。该患者有未控制的糖尿病史,左脚踝有坏死性病变,提示侵袭性感染性真菌病。包括组织染色和分子分析在内的诊断程序确定了致病微生物。给予两性霉素B后病情显著改善,但患者需要进行大腿中部截肢以阻止感染进展,最终治疗后成功出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1714/10850049/f1243ce92467/rjae003f1.jpg

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