- 期刊
Vibrio Vulnificus Necrotizing Fasciitis of the Lower Limb-A Case Report and Literatures Review
創傷弧菌感染導致下肢壞死性筋膜炎－病例報告及文獻回顧
摘要
創傷弧菌是一種遍及全球的病原體，主要在溫暖的沿海水域裡發現。其感染大部分是在炎熱的夏季發生。人類感染創傷弧菌一般是因食用受到污染的生或未煮熟的海鮮，又或者直接由傷口接觸到污染的海水或海生動物所引起。創傷弧菌感染的潛伏期從數小時到數天不等，其三種主要的臨床症狀為原發性敗血症，軟組織感染和腸胃炎。在某些易感的病人中，創傷弧菌感染可能會導致致命性的疾病，特別是罹患肝臟疾病或者糖尿病的患者。從一九九二年至今，本院有十五位患者被診斷為創傷弧菌感染。本文描述一位四十二歲的男性酒癮患者以休克症狀及急性左下肢壞死性筋膜炎作為創傷弧菌感染的最初症狀表現。雖然一般來說，創傷弧菌感染的潛伏期是數小時至數天，但已有報告發現更長的潛伏期。因此詳盡的詢問病史對於鑑別診斷及治療是相當重要的。因為創傷弧菌感染導致敗血症合併壞死性筋膜炎的死亡率非常高，所以如果強烈懷疑創傷弧菌感染時，早期診斷及合併使用靜脈注射廣效性抗生素和外科切除壞死組織可以減少罹病率及死亡率。
關鍵字
無資料並列摘要
Vibrio vulnificus, a worldwide virulent pathogen, is mainly found in warm coastal waters. The infections due to this pathogen occur in the hot summer season. Human infections are usually acquired through consumption of contaminated raw seafood or direct invasion through wounds by contaminated seawater or marine animals. The incubation period ranges from a few hours to days. The three main clinical presentations of Vibrio vulnificus were primary septicemia, soft tissue infection, and gastroenteritis. A life-threatening illness may develop in susceptible individuals, particularly patients with preexisting liver diseases or diabetes. Fifteen patients were diagnosed as having Vibrio vulnificus infection in our hospital since 1992, and one patient, a 42-year-old alcoholic male, presented with syndromes of shock and acute necrotizing fasciitis on left lower limb as the initial manifestation of Vibrio vulnificus infection. Incubation times may vary among individuals, and therefore careful history taking is very important for accurate differential diagnosis and treatment. The mortality of septicemia with Vibrio vulnificus necrotizing fasciitis is very high. If infection of V. vulnificus is strongly suspected, early diagnosis with broad spectrum intravenous antibiotics and surgical excision of devitalized tissues are essential to decrease morbidity and mortality.
延伸閱讀
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