Successful surgical treatment of polybacterial gas gangrene confirmed by metagenomic next-generation sequencing detection:A case report  

作　　者：Hong-Yan Lu Yan-Bin Gao Xue-Wen Qiu Qi Wang Chen-Mei Liu Xiao-Wen Huang Hong-Yu Chen Kang Zeng Chang-Xing Li 

机构地区：[1]Department of Dermatology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong Province,China [2]Department of Burns Surgery,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong Province,China

出　　处：《World Journal of Clinical Cases》2022年第35期13064-13073,共10页世界临床病例杂志

基　　金：National Natural Science Foundation of China,No.82173437;and Natural Science Foundation of Guangdong Province,No.2020A15150875.

摘　　要：BACKGROUND We report on a case of Vibrio vulnificus(V.vulnificus)detected by metagenomics next-generation sequencing(mNGS)in a 53-year-old male patient with polymicrobial gas gangrene and successful treatment by surgery.This report raises awareness among dermatologists that when a patient is clinically suspected of a special type of pathogenic infection,the mNGS method should be preferred to identify the patient’s pathogen infection as soon as possible and then take effective treatment in time to save patients’lives.CASE SUMMARY A 53-year-old male who worked in the aquatic market complained of redness and swelling of the lower limbs,blisters and ulcers with fever for 3 d.We used mNGS to test the pathogens in ulcer secretions.The results were returned in 24 h and indicated:V.vulnificus,Fusobacterium necrophorum,Staphylococcus haemolyticus,Staphylococcus aureus,Streptococcus dysgalactiae and Klebsiella aerogenes.This patient was diagnosed with V.vulnificus infection.The emergency operation was performed immediately under combined lumbar and epidural anesthesia:Left leg expansion and exploration(August 10,2021).After surgery,we continued to use piperacillin sodium tazobactam sodium 4.5 g every 8 h and levofloxacin 0.5 g for anti-infection treatment.The patient underwent further surgery under lumbar anesthesia on August 17,2021 and August 31,2021:Left leg deactivation and skin grafting,negative pressure closed drainage and right thigh skin removal.After treatment,the transplanted flap survived.CONCLUSION We could confirm the diagnosis of Vibrio vulnificus infection within 24 h through mNGS detection and then immediately performed emergency surgery.

关 键 词：Metagenomics next-generation sequencing Vibrio vulnificus Polymicrobial gas gangrene SURGERY Case report 

分 类 号：R633.2[医药卫生—外科学]