Anderson L L, Giandoni M B, Keller R A, Grabski W J
Dermatology Service, Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
Dermatol Surg. 1995 Sep;21(9):799-801. doi: 10.1111/j.1524-4725.1995.tb00301.x.
An unusual complication of cutaneous surgery and its management is presented. Aspergillus flavus was identified from a nonhealing surgical wound of the ear undergoing cartilaginous necrosis in an immunocompetent host.
We wish to alert clinicians that Aspergillus may infect surgical wounds of the ear causing significant morbidity.
A healthy man underwent Mohs micrographic surgery for invasive Bowen's disease of the ear. Due to the size and location of the defect it was allowed to heal by secondary intent. The patient developed inflammation and subsequent destruction of the ear cartilage. Aspergillus was demonstrated by touch preps and cultured from swabs and tissue from the necrotic wound.
In spite of aggressive topical and oral antifungal therapy severe distortion of the pinna occurred, resulting in surgical removal of the upper two-thirds of the ear.
In the presence of cartilage necrosis following surgery on the ear, Aspergillus infection should be considered. Early aggressive management with surgical debridement, and topical and oral antifungal therapy may prevent destruction of the cartilage and a significant cosmetic defect.
介绍了一种皮肤外科手术的罕见并发症及其处理方法。在一名免疫功能正常的宿主中，从耳部软骨坏死的不愈合手术伤口中鉴定出黄曲霉。
我们希望提醒临床医生，曲霉可能感染耳部手术伤口，导致严重的发病率。
一名健康男性因耳部侵袭性鲍恩病接受了莫氏显微外科手术。由于缺损的大小和位置，伤口采用二期愈合。患者出现炎症，随后耳部软骨遭到破坏。通过触片检查证实有曲霉，并从坏死伤口的拭子和组织中培养出曲霉。
尽管积极进行了局部和口服抗真菌治疗，耳廓仍出现严重变形，导致切除了耳廓上三分之二。
耳部手术后出现软骨坏死时，应考虑曲霉感染。早期积极采用手术清创、局部和口服抗真菌治疗，可防止软骨破坏和严重的美容缺陷。
