PDF(Pubmed)
Abstract：
Pythiosis is caused due to a filamentous eukaryotic micro-organism called Pythium insidiosum and the disease occurs commonly in horses and cattle. Subcutaneous pythiosis infection in humans is rare with no clear clinical guidelines for treatment. We present a case of a man in his 20s with non-resolving ulcers noted over lower extremity after exposure to swamp water draining animal remains. The patient received several courses of oral antibiotics with no improvement in symptoms before getting admitted to our institution. A diagnosis of subcutaneous pythiosis was made after deep wound culture following debridement detected P. insidiosum by use of PCR. Due to the rare incidence of such infection in humans and no clear guidelines available for treatment, the case was discussed with infectious disease specialists outside our institution and with veterinary physicians. An emergent approval for use of immunotherapy in conjunction with surgical debridement and antimicrobials was obtained from Food and Drug administration. The patient underwent successful treatment of infection and skin graft following treatment.
摘要：
化脓症是由一种丝状真核微生物引起的，这种微生物被称为化脓霉，这种疾病通常发生在马和牛中。人类皮下脓毒血症感染很少见，没有明确的临床治疗指南。我们介绍了一例20多岁的男子，在暴露于沼泽排水动物遗骸后，下肢出现了无法解决的溃疡。患者在入院之前接受了几个疗程的口服抗生素，症状没有改善。在清创术后深层伤口培养后，通过PCR检测了阴阳假单胞菌，诊断为皮下化脓。由于此类感染在人类中的罕见发生率，并且没有明确的治疗指南，与我们机构外的传染病专家和兽医讨论了该病例。从食品和药物管理局获得了与手术清创和抗微生物剂结合使用免疫疗法的紧急批准。患者接受了成功的感染治疗和治疗后的皮肤移植。
