Abstract
一位六十六歲的男性病人因兩側腎盞結石住院接受治療。住院後意外在MRCP檢查中發現左側臀部深處有一分葉的病灶。病理切片顯示?真菌Mucorales感染。廣泛的外科清創手術及早期抗真菌藥物amphotericin B的使用使此病灶逐漸消退。治療後電腦斷層追蹤發現右側臀部有注射肉牙腫的情形。此病例說明了在注射類固醇濫用的病人中發生mucormycosis感染的情形。整形外科醫師對健康但曾濫用類固醇的病人應存有高度懷疑可能會發生皮膚mucormycosis的感染。及早的外科清創，抗真菌藥物的使用，及最後的重建手術可導致滿意的結果。
A 66-year-old male patient was hospitalized due to bilateral caliceal stones. A lobulated lesion in the left great gluteal muscle region was found incidentally on magnetic resonance cholangiopancreatography (MRCP) after admission. Extensive surgical debridement was performed, along with early use of intravenous amphotericin B, after demonstration of Mucorales hyphae in the pathologic specimen. With the aid of subsequent abdominal computed tomography (CT), history of frequent intramuscular drug injection and successive low serum cortisol levels, injection granulomas in the right gluteal region due to steroid abuse were diagnosed. This case demonstrated the occurrence of mucormycotic infection in patients with steroid abuse. Plastic surgeons should have a high index of suspicion regarding cutaneous mucormycosis in individuals with a history of intramuscular steroid injection. Early implementation of aggressive surgical debridement, administration of empiric antifungal medications, and definitive reconstruction are necessary to obtain a successful outcome.
A 66-year-old male patient was hospitalized due to bilateral caliceal stones. A lobulated lesion in the left great gluteal muscle region was found incidentally on magnetic resonance cholangiopancreatography (MRCP) after admission. Extensive surgical debridement was performed, along with early use of intravenous amphotericin B, after demonstration of Mucorales hyphae in the pathologic specimen. With the aid of subsequent abdominal computed tomography (CT), history of frequent intramuscular drug injection and successive low serum cortisol levels, injection granulomas in the right gluteal region due to steroid abuse were diagnosed. This case demonstrated the occurrence of mucormycotic infection in patients with steroid abuse. Plastic surgeons should have a high index of suspicion regarding cutaneous mucormycosis in individuals with a history of intramuscular steroid injection. Early implementation of aggressive surgical debridement, administration of empiric antifungal medications, and definitive reconstruction are necessary to obtain a successful outcome.
| Original language | American English |
|---|---|
| Pages (from-to) | 260-264 |
| Journal | Formosan Journal of Surgery |
| Volume | 40 |
| Issue number | 6 |
| State | Published - 2007 |