愈溃膏治疗臁疮的临床评价

目的探讨治疗臁疮的有效方药;方法应用白行研制的愈溃膏,采用外敷的方法,治疗臁疮80例,同期常规治疗45例作为对照;结果应用愈溃膏治疗80例患均取得较好效果,明显优于对照组;结论愈溃膏对于臁疮有较好疗效。     

祛瘀法治疗疮疡病的临床体会

运用祛瘀法为主，结合清热、化湿、养阴、理气法以及祛腐、生肌、拖线、灌注等内外合治法，治疗臁疮、窦瘘、脱疽、股肿等疮疡疾病，并附验案四则。     

Ecthyma gangrenosum in a 3‐year‐old boy post‐heart transplantation

Ecthyma gangrenosum (EG) is a serious bacterial infection in immunocompromised patients. EG in transplant recipients is rarely reported and may go unrecognized, which may delay initiation of appropriate treatment. We report a case of EG in a pediatric heart transplant recipient who was treated successfully with antibiotics and surgical debridement.     

清营方中药熏洗结合疮面缠缚治疗臁疮疗效观察

目的观察清营方熏洗疮面结合疮面缠缚治疗臁疮的临床疗效。方法将60例臁疮患者分为2组,治疗组30例采用疮面敷药加缠缚治疗,同时予以自拟清营方熏洗溃疡疮面,对照组30例采用疮面敷药加缠缚治疗。治疗3个月后观察2组临床疗效、溃疡疮面愈合时间及溃疡复发率。结果治疗组临床治愈率90%,溃疡愈合时间为12～112 d,溃疡复发率8%;对照组临床治愈率77%,溃疡愈合时间为16～149 d,溃疡复发率29%。治疗组的临床治愈率、溃疡愈合时间均优于对照组,溃疡复发率低于对照组。结论清营方中药熏洗结合疮面缠缚治疗臁疮效果更好。     

Ecthyma gangrenosum caused by Staphylococcus aureus in hematological malignancies: Case reports and literature review

Rationale:Ecthyma gangrenosum (EG) is a potentially life-threatening, systemic infection generally caused by Pseudomonas aeruginosa. Data on EG caused by Staphylococcus aureus in patients with hematological malignancies are scarce. The present case report aimed to describe the clinical features of EG caused by S. aureus in patients with hematological malignancies and to provide a comprehensive review of previous studies on the topic.Patient concerns:The first patient was a 61-year-old man with acute myeloid leukemia who presented fever and multiple lesions during chemotherapy. The second patient was a 47-year-old man with myelodysplastic syndrome who developed progressive erythematous necrotic plaques on his extremities and face.Diagnosis:Both cases were diagnosed as EG caused by S. aureus. While the first patient had concurrent methicillin-resistant S. aureus (MRSA) bacteremia, the second patient had positive results only for tissue culture of the skin lesion isolated methicillin-sensitive S. aureus.Interventions:Vancomycin was initiated with critical care to the first patient. Cefazolin was administered to the second patient for 3 weeks, followed by cephalexin for 1 week.Outcomes:The first patient died of a brain hemorrhage and multiple organ failure. The second patient was cured without relapse.Lessons:Of 18 patients in the previous and current studies with EG caused by S. aureus, 6 (33%) had an underlying hematological malignancy, and 10 (56%) had EG caused by MRSA. While 28% of the patients had positive blood cultures, all tissue cultures were positive. All 3 fatalities had concurrent bacteremia (MRSA caused two). EG caused by MRSA with concurrent bacteremia can be fatal, especially in patients with hematological malignancies. Although S. aureus-associated EG in patients with hematological malignancies is relatively uncommon, tissue cultures with an initial gram stain smear are essential for selecting appropriate empirical antimicrobials, including the coverage of S. aureus.     

Community acquired fulminant Pseudomonas infection of the gastrointestinal tract in previously healthy infants

Three previously healthy infants presented with diarrhoea and pyrexia and deteriorated rapidly. Two patients had necrotizing bowel disease requiring aggressive surgical intervention. All survived. P. aeruginosa gastrointestinal infection in previously healthy children is an extremely rare condition with a high mortality. Ecthyma gangrenosum was present in over 60% of reported cases although often not recognized initially. A high index of clinical suspicion, including prompt recognition of ecthyma gangrenosum, is mandatory for an early diagnosis of P. aeruginosa gastrointestinal infection. Early diagnosis and treatment may improve the prognosis.