因非O1，非O139型霍亂弧菌感染致壞死性筋膜炎：一病例報告

Necrotizing Fasciitis Due to Non - O1, Non - O139 Vibrio Cholerae Infection: A Case Report

李俊杰(Chun-Chieh Lee) ； 蘇世斌(Shih-Bin Su) ； 莊銀清(Yin-Ching Chuang) ； 秦凌霄(Lin-Show Chin)

《中華民國急診醫學會醫誌》 4卷4期 (2002/12) Pp. 193-198

摘要

一位44歲肝硬化患者因非O1、非O139型霍亂弧菌(non-O1, non-O139 Vibrio cholerae)感染致壞死性筋膜炎而截肢。在入院前一天患者於自宅食用生魚片與生文蛤，次日即突發高燒併雙小腿紅腫脹痛，檢視雙足無外傷。於住院第二日立即行雙側小腿筋膜切除術，組織細菌境養證實為非O1，非O139型霍亂弧菌感染。在抗生素治療與骨科擴創截肢治療後，於病發六週後病情穩定出院。此急症的死亡率高；在肝硬化的患者，若有生食海鮮或親近水域的活動，當出現快速進行的皮膚軟組織感染時，應懷疑此症之可能性。

關鍵字

非O1 ； 非O139型霍亂弧菌 ； 壞死性筋膜炎 ； 肝硬化 ； 生文蛤

並列摘要

A 44-year-old man with liver cirrhosis was brought to our Emergency Room after an abrupt onset of high fever and aggressive progression of erythema, pain and swelling of the lower extremities. The patient had ingested raw clams and sashimi at home in the evening on the day prior to presentation. A fasciotomy of both lower limbs was carried out on the second hospital day, later followed by amputation. Tissue cultures yielded non-O1, non-O139 Vibrio cholerae. Owing to the high fatality rate of non-O1, non-O139 V. cholerae infection, it is important to consider this diagnosis in patients with liver cirrhosis and rapid progression of skin infection.

並列關鍵字

Non-O1 ； non-O139 Vibrio cholerae ； necrotizing fasciitis ； liver cirrhosis ； raw clam