A Survived Case of Nonclostridial Gas Gangrene in a Diabetic Patient

文獻上報告造成氣性壞疽常見的原因是梭菌性感染，但非梭菌性感染造成的氣性壞疽很少被報告。很多其它的細菌也會造成氣性壞疽，特別是在糖尿病患者。我們必須熟悉區分梭菌性及非梭菌性的氣性壞疽，因爲處理上有所不同。因爲非梭菌性氣性壞疽對高壓氧治療較沒效果，可能更須積極清創及抗生素使用。我們報告一個糖尿病患者罹患左大腿非梭菌性氣性壞疽（肺炎桿菌），經過數次清創及積極的抗生素使用，最後康複的病例。

關鍵字

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並列摘要

The usual causative organisms in gas gangrene are clostridial species, while nonclostridial gas gangrene is infrequently reported. A variety of other organisms including Escherichia coli, Streptococcus faecalis, aerobic Streptococcus, Proteus, Bacteroides, and Klebsiella species may cause infection in which gas is demonstrable, particularly in patients with diabetes mellitus. It is important to familiarize ourselves with these nonclostridial crepitant infections, which are often confused with clostridial myonecrosis. The medical and surgical management is substantially different between clostridial and non-clostridial gas gangrene. We present a case of diabetes with nonclostridial (klebisella pneumoniae) gas gangrene of the left thigh. Multiple debridement and aggressive antibiotics were used to rescue the patient. Eventually, split thickness skin grafting was performed to cover the wound. The patient had a good recovery after ten weeks of admission.

並列關鍵字

nonclostridial gas gangrene ； clostridial gas gangrene ； necrotizing fasciitis

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A Survived Case of Nonclostridial Gas Gangrene in a Diabetic Patient

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