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題名 | Necrotizing Fasciitis Caused by Serratia Marcescens in Two Patients Receiving Corticosteroid Therapy=Serratia marcescens在兩位服用類固醇病患引起壞死性肌膜炎 |
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作者 | 黃政文; 方啟泰; 洪冠予; 薛博仁; 張上淳; 蔡敦仁; | 書刊名 | 臺灣醫學會雜誌 |
卷期 | 98:12 1999.12[民88.12] |
頁次 | 頁851-854 |
分類號 | 418.11 |
關鍵詞 | 類固醇; 壞死性肌膜炎; Corticosteroid therapy; Necrotizing fasciitis; Nephrotic syndrome; Serratia marcescens; Uremia; |
語文 | 英文(English) |
英文摘要 | Necrotizing fasciitis (NF), a devastating soft tissue infection, is rarely attributed to Serratia marcescens. We here report two patients with S. marcescens NF, both of whom had underlying renal disease and had been receiving corticosteroid therapy. The first patient, a 40-year-old man with systemic lupus erythematosus and uremia on prednisolone therapy, developed fulminant cellulitis and septic shock 1 month after a skin biopsy for cutaneous vasculitis of the left foot. The cellulitis evolved to NF, and blood and necrotic tissue cultures both grew S. marcescens. The patient completely recovered after debridement and ceftazidime therapy. The second patient, a 73-year-old man receiving prednisolone therapy for nephrotic syndrome, developed right leg cellulitis that evolved to NF. Blood and necrotic tissue cultures both grew S. marcescens. After aggressive debridement and ciprofloaxcin therapy, the NF improved. However, the patient died of aspiration pneumonia and massive gastrointestinal bleeding 1 month later. There findings illustrate that S. marcescens should be considereded as a potential pathogen causing NF in susceptible hosts. |
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