Vascular Pythiosis of the Lower Extremity in Northern Thailand: Ten Years' Experience.
Pythiosis is a disease caused by Pythium insidiosum, a fungus-like organism. P. insidiosum is pathogenic in mammals, particularly in horses, dogs, and humans. Human pythiosis can be classified into 4 types: (1) cutaneous/subcutaneous, (2) ocular, (3) vascular, and (4) disseminated pythiosis. Vascular pythiosis is a rare disease but a serious limb- and life-threatening infection. We reviewed 22 cases over a 10-year period in Maharaj Nakorn Chiang Mai/Chiang Mai University Hospital. The survival rate was around 63.6% during our follow-up period. The only effective treatment was complete excision of the infected tissue, which was done mainly by major amputation, such as above-knee amputation. This report raises awareness of this disease, which needs preemptive diagnosis and appropriate treatment.
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Termpong
T
Reanpang
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Saritphat
S
Orrapin
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Saranat
S
Orrapin
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Supapong
S
Arworn
Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Thanate
T
Kattipatanapong
Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Tanop
T
Srisuwan
Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Nongnuch
N
Vanittanakom
Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Suree P
SP
Lekawanvijit
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Research Institute of Health Science, Chiang Mai University, Thailand rerkase@gmail.com.
Kittipan
K
Rerkasem
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003646:Debridement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D015994:Incidence; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D058968:Pythiosis / Q000453:epidemiology* / Q000382:microbiology / Q000601:surgery; D011775:Pythium / Q000302:isolation & purification; D012189:Retrospective Studies; D013785:Thailand / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D055815:Young Adult
Pythium insidiosum; aneurysm; gangrene; pythiosis