METHODS: A 34 year old female with lymphoedema of the lower limb, underwent silicone tube implantation. Ten months after surgery, the patient presented with fever and dermatolymphangioadenitis of the limb. Ultrasound suggested an abscess surrounding the tubes. Clinical improvement was achieved after a 6-day cycle of meropenem. She was discharged under oral cefuroxime and clindamycin for one week. After 1 month, CT-angiography was performed showing only residual inflammation surrounding the tubes, the patient was asymptomatic and limb diameter was normal.
CONCLUSIONS: Sudden onset and improvement of the patient\'s condition after a short cycle of antibiotics without the need of tube removal supports a host-like reaction rather than an actual infection. Doctors should be aware of such complications avoiding unnecessary procedures.
方法:34岁女性,下肢淋巴水肿,进行硅胶管植入。手术后十个月,患者出现发热和肢体皮肤淋巴管炎。超声提示导管周围有脓肿。美罗培南6天周期后,临床症状有所改善。她在口服头孢呋辛和克林霉素下出院一周。一个月后,CT血管造影显示只有导管周围残留的炎症,患者无症状,肢体直径正常。
结论:在不需要拔管的情况下,短周期抗生素的突然发作和患者病情的改善支持宿主样反应,而不是实际感染。医生应该意识到这种并发症,避免不必要的手术。