創傷弧菌感染併發壞死性筋膜炎－病例報告

創傷弧菌(Vibrio Vulnificus)是一種全世界分佈的致病菌，特別是20度C以上的海域及海洋生物中。在溫暖的夏季，幾乎100%的牡蠣存有創傷弧菌。創傷弧菌所引起的症狀包括：發燒、畏寒、皮膚病灶、休克、腹瀉、嘔吐。大部分的病人被發現有程度各異的肝臟疾病，包括：肝硬化、鐵質沈著症、慢性肝炎。本篇論文描述一位男性43歲病患，職業為海鮮店員工，於工作期間不小心被龍蝦螫傷於右手腕，三天後於左下肢產生紅腫疼痛的現象，至診所求治後返家，發現肢體紅腫更為明顯，隨後至急診就醫，於急診室中，發現病患左下肢有紅腫熱痛現象，且於兩側大腿發現有出血性水泡產生，病人有二十多年飲酒習慣，而且有海洋性創傷病史。臨床診斷為創傷弧菌感染併發壞死性筋膜炎，由急診直入開刀房做清創手術，四天後病患因敗血性休克合併多器官衰竭死亡。

關鍵字

創傷弧菌；肝硬化；壞死性筋膜炎；敗血性休克；清創手術

並列摘要

Vibrio Vulnificus was a worldwide bacteria, living in the sea and marine creatures with sea temperature above 20℃. During warm summer seasons, almost 100% of oysters had Vibrio Vulnificus. The syndromes caused by Vibrio Vulnificus infection included high fever, chills, skin lesion, shock, diarrhea, vomitus. Most of patients infected seriously by Vibrio Vulnificus had different degrees of liver diseases, including liver cirrhosis, hemochromatosis, and chronic hepatitis. This article described that a male patient, an employee of sea food shop, was injuried by a lobster over right wrist. Three days later, painful swelling and redness were noted over left low leg. He was brought to private medical office for treatment then back to home. Progressive swelling and painful sensation were more and more obvious, so he was brought to emergency room for treatment. He was reviewed and severe painful sensation and swelling found over left low leg and hemorrhagic vesicles noted at both thighs. Patient had heavy drinks about 20 years and had the experience of marine trauma. Vibrio Vulnificus infection complicated with necrotizing fasciitis was impressed. We arranged surgical debridement at emergency room. Four days later, patient died of septic shock and multiple organ failure.

並列關鍵字

Vibrio Vulnificus ； Cirrhosis ； Necrotizing fasciitis ； Septic shock ； Debridement

國際替代計量

創傷弧菌感染併發壞死性筋膜炎－病例報告

全文下載

主題瀏覽