Musch Brian, Daley Rachel A, McMandon Alyssa, Biswas Saptarshi
Surgery, Grand Strand Medical Center, Myrtle Beach, USA.
Medicine, Edward Via College of Osteopathic Medicine, Spartanburg, USA.
Cureus. 2025 May 17;17(5):e84273. doi: 10.7759/cureus.84273. eCollection 2025 May.
Necrotizing myonecrosis is a life-threatening infection of the skeletal muscle and soft tissues, predominantly caused by bacteria such as and . In rare cases, fungal organisms, particularly , have been identified as the sole causative agent in these infections. We present a rare case of a 77-year-old female patient who underwent an elective hysterectomy that was complicated by an iatrogenic injury to her small bowel, which was missed in the preliminary surgery. Postoperatively, she developed signs of peritonitis and greenish-brown drainage from her incision site. Exploratory laparotomy confirmed small bowel perforation. Subsequently, she developed abdominal sepsis and necrotizing myonecrosis involving the anterior abdominal wall musculature. Empiric treatment with broad-spectrum antibiotics was initiated. Intraoperative cultures revealed isolated , prompting a shift in management to antifungal therapy and multiple surgical debridements of the anterior musculature.
坏死性肌坏死是一种危及生命的骨骼肌和软组织感染，主要由诸如……和……等细菌引起。在罕见情况下，真菌生物，尤其是……，已被确定为这些感染的唯一病原体。我们报告一例罕见病例，一名77岁女性患者接受了择期子宫切除术，术中因医源性小肠损伤而在初次手术中被遗漏。术后，她出现腹膜炎体征及切口部位绿褐色引流液。剖腹探查术证实小肠穿孔。随后，她发生腹部脓毒症及累及前腹壁肌肉组织的坏死性肌坏死。开始经验性使用广谱抗生素治疗。术中培养显示分离出……，促使治疗方案转变为抗真菌治疗及对前腹壁肌肉组织进行多次手术清创。
