首页|念珠菌属引起肛周阴囊部坏死性筋膜炎合并化脓性肌炎1例

念珠菌属引起肛周阴囊部坏死性筋膜炎合并化脓性肌炎1例

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患者男性,42岁,既往有乙型病毒性肝炎与膜性肾病病史,入院12 d前间断发热、寒战,入院近2d加重伴左侧阴囊及会阴部红肿疼痛,立即给予手术清创,患者持续低热,血培养及脓液培养结果为近平滑念珠菌,确诊为真菌类坏死性筋膜炎及化脓性肌炎,选用棘白菌素类米卡芬净(150 mg,qd)抗真菌感染治疗,期间给予蚕食换药、高压氧疗、营养支持等,术后2个月患者病情好转出院.念珠菌属感染引起的坏死性筋膜炎及化脓性肌炎早期临床症状均缺乏特异性,易延误病情,对于合并免疫疾病的患者应注意复杂感染的预防和早期治疗,前期恰当的经验性选用抗真菌药物具有重要的临床意义.
Perianal scrotal necrotizing fasciitis combined with pyomyositis caused by Candida spp.:a case report
The patient,a 42-year-old male,with a history of hepatitis B and membranous nephropathy,had inter-mittent fever and chills 12 days before admission.In the first 2 days after admission,the patient's condition aggra-vated with redness,swelling and pain in the left scrotum and perineum.Immediate surgical debridement was per-formed.The patient had a persistent low fever,with blood and pus cultures showing Candida albicans positive,thus was diagnosed fungal necrotizing fasciitis and pyomyositis.The patient was treated with echinocandins mica-fungin(150 mg,qd)for antifungal infection,and was given encroaching dressing change,hyperbaric oxygen thera-py,nutritional support,etc.Two months after surgery,the patient's condition improved and he was discharged.The early clinical symptoms of necrotizing fasciitis and pyomyositis caused by Streptococcus spp.infection lack spe-cificity,thus are prone to be delayed.For patients with concomitant immune diseases,attention should be paid to the prevention and early treatment of complex infection.The appropriate selection of empirical antifungal agents at the early stage has clinical significance.

Candida spp.necrotizing fasciitispyomyositisinfectionCandida albicans

徐雪丽、席作武、王炎炎、周琼阁、邓珂欣

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河南中医药大学第二临床医学院,河南 郑州 450046

河南省中医院肛肠科,河南 郑州 450002

念珠菌属 坏死性筋膜炎 化脓性肌炎 感染 假丝酵母菌

2024

中国感染控制杂志
中南大学

中国感染控制杂志

CSTPCD北大核心
影响因子:2.112
ISSN:1671-9638
年,卷(期):2024.23(11)