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Geleneksel Tedaviden Büyük Bir Ampütasyona: Zooterapi Kaynaklı Nekrotizan Yumuşak Doku Enfeksiyonu

Yıl 2025, Cilt: 16 Sayı: 3, 114 - 117, 30.09.2025

Öz

Özet
Giriş: Sağlık hizmetlerine erişimin kısıtlı olduğu veya sağlık okuryazarlığının düşük olduğu toplumlarda tıbbi geçerliliği olmayan geleneksel uygulamalar yaygın olarak kullanılmaktadır. Steril koşullardan uzak bu tür müdahaleler, ciddi yumuşak doku enfeksiyonlarına ve doku nekrozuna yol açabilir. Bu olgu sunumunda, alt ekstremite travması sonrası hayvan akciğeri uygulanmasını takiben gelişen yaygın selülit, doku nekrozu ve amputasyonla sonuçlanan nadir bir klinik tablo sunulmaktadır.
Olgu: Doksan yaşındaki erkek hasta, ayak bileği burkulması sonrası travmalı bölgeye steril olmayan koyun akciğeri dokusu sarmıştır. Başvurusunda yaygın eritem, ödem, kötü kokulu akıntı ve sistemik inflamasyon bulguları saptanmıştır. Geniş spektrumlu antibiyotik tedavisine rağmen ilgili ekstremitede arteriyel oklüzyon gelişmiş ve progresif iskemik süreç sonunda majör amputasyon uygulanmak zorunda kalınmıştır.
Sonuç: Bu vaka, modern tıp dışı müdahalelerin yol açabileceği ciddi komplikasyonlara dikkat çekmektedir. Özellikle ileri yaş ve komorbid bireylerde bu tür uygulamalar geri dönüşsüz sonuçlara yol açabilir. Erken tanı ve etkili tıbbi müdahale, benzer olguların mortalite ve morbiditesini azaltmada hayati önem taşır.

Etik Beyan

Bu çalışma etik ilkelere uyularak yazılmıştır.

Kaynakça

  • 1. World Health Organization. WHO global report on traditional and complementary medicine 2019. Geneva: WHO; 2019 [cited 2025 Apr 26]. Available from: https://iris.who.int/handle/10665/312342
  • 2. Stevens DL, Bryant AE. Necrotizing soft-tissue infections. N Engl J Med. 2017;377(23):2253–2265. doi:10.1056/ NEJMra1600673.
  • 3. McDermott FD, Collins D, O’Connell PR. Necrotizing soft tissue infections: a review. JAMA Surg. 2024;159(11):1308–1315. doi:10.1001/jamasurg.2024.2217.
  • 4. Hall H, Majyambere D, Sibomana E, Uwase S, Mahoro J, Amuguni HJ, et al. A mixed methods study of zootherapy practices and associated risks for zoonotic disease spillover in Rwanda. Discover Anim. 2024 Dec 24; 1:41. doi:10.1007/s44338-024-00027-w
  • 5. Torresetti M, Peltristo B, Taddei FMJ, Di Benedetto G. Aeromonas hydrophila infection following leech therapy for the treatment of nipple–areola complex congestion after breast reduction: a case report. Arch Plast Surg. 2024 Apr;51(3):317–320. doi:10.1055/s-0043-1776696
  • 6. McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA. Determinants of mortality for necrotizing softtissue infections. Ann Surg. 1995;221(5):558–63. doi:10.1097/00000658-199505000-00013.
  • 7. Alajmi T, Aljulaihim A, Alzahrani M, Aljuhayyiam S. Necrotizing Fasciitis Following Wet Cupping: A Case Report. Am J Case Rep. 2021;22: e931462. doi:10.12659/AJCR.931462.
  • 8. Wang YH, Chen WT. Foreign body cystic granuloma and abscess after acupoint catgut embedding. J Formos Med Assoc. 2021;120(5):1140–1141. doi:10.1016/j.jfma.2021.02.002.
  • 9. Collins CM, McCarty A, Jalilvand A, et al. Outcomes of patients with necrotizing soft tissue infections: a propensity-matched analysis using the National Inpatient Sample. Surg Infect (Larchmt). 2022 Apr;23(3):304–312. doi:10.1089/sur.2021.317
  • 10. Çalbay A, Bayramoğlu A, Karadeniz E. What are the Alternatives to the LRINEC Score in Identifying Necrotizing Soft Tissue Infections in the Emergency Department? Eurasian J Crit Care. 2022 Aug;4(2):41–46. doi:10.55994/ejcc.1135938
  • 11. Zacharias N, Velmahos GC, Salama A, Alam HB, de Moya M, King DR, Novelline RA. Diagnosis of necrotizing soft tissue infections by computed tomography. Arch Surg. 2010;145(5):452–5. doi:10.1001/archsurg.2010.50.
  • 12. Martinez M, Peponis T, Hage A, Yeh DD, Kaafarani HMA, Fagenholz PJ, et al. The role of computed tomography in the diagnosis of necrotizing soft tissue infections. World J Surg. 2018;42(1):82–87. doi:10.1007/s00268-017-4145-x.
  • 13. Guliyeva RA, Baranova AY, Kartashov AV, et al. Practical review of necrotizing fasciitis: Principles and evidencebased management. J Surg Res. 2024 Jan;284:189–197. doi:10.1016/j.jss.2023.10.003.
  • 14. Prabhu S, Reddy S, Reddy S, et al. Necrotizing fasciitis: treatment concepts & clinical outcomes. J Clin Med. 2023 Jun;12(6):1832. doi:10.3390/jcm12061832.
  • 15. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jul;59(2):e10–52. doi:10.1093/cid/ciu296.
  • 16. Wei X, Huo J, Yang Q, Li J. Early diagnosis of necrotizing fasciitis: Imaging techniques and their combined application. Int Wound J. 2024 Jan;21(1):e14379. doi:10.1111/iwj.14379.
  • 17. Bilgili P, Gümüştakım RS, Cevik M, Baser DA, Doğaner A, Coşkun E, et al; AHEF BilimKurulu. Turkish primary care patients’ overviews and attitudes about traditional and complementary medicine: a cross-sectional study. Med Bull Haseki. 2023;61(4):238–246. doi:10.4274/haseki.galenos.2023.9276.

From a Traditional Treatment to a Major Amputation: A Zootherapy-Induced Necrotizing Soft Tissue Infection

Yıl 2025, Cilt: 16 Sayı: 3, 114 - 117, 30.09.2025

Öz

Abstract
Introduction: Non-evidence-based traditional practices are still widely used in communities with limited access to healthcare or low health literacy. The non-sterile nature of such interventions may predispose individuals to severe soft tissue infections and tissue necrosis. This case report presents a clinical scenario involving widespread cellulitis, necrosis, and eventual amputation following the application of animal lung tissue after lower extremity trauma.
Case Presentation: A 90-year-old male patient applied non-sterile animal lung tissue to the traumatized area following an ankle sprain. Upon admission, widespread erythema, edema, localized heat increase, foul-smelling discharge, and signs of systemic inflammation were observed in the affected foot. Clinical and radiological evaluations revealed cellulitis, necrosis, and deep soft tissue infection. Broad-spectrum antibiotic therapy was initiated. However, during follow-up, in addition to progressive infection, arterial occlusion developed in the affected extremity. Despite all medical and surgical interventions, no clinical response was achieved, and major amputation was ultimately performed.
Conclusion: Non-evidence-based local practices may lead to serious infectious complications and irreversible outcomes, particularly in elderly individuals. This case, which is rarely reported in the literature, highlights a clinical course involving widespread cellulitis, tissue necrosis, arterial occlusion, and ultimately major amputation following the application of non-sterile animal lung tissue. The presented case demonstrates the destructive impact of non-medical interventions and emphasizes the importance of early diagnosis and management in similar situations

Etik Beyan

This study was conducted in accordance with ethical principles.

Kaynakça

  • 1. World Health Organization. WHO global report on traditional and complementary medicine 2019. Geneva: WHO; 2019 [cited 2025 Apr 26]. Available from: https://iris.who.int/handle/10665/312342
  • 2. Stevens DL, Bryant AE. Necrotizing soft-tissue infections. N Engl J Med. 2017;377(23):2253–2265. doi:10.1056/ NEJMra1600673.
  • 3. McDermott FD, Collins D, O’Connell PR. Necrotizing soft tissue infections: a review. JAMA Surg. 2024;159(11):1308–1315. doi:10.1001/jamasurg.2024.2217.
  • 4. Hall H, Majyambere D, Sibomana E, Uwase S, Mahoro J, Amuguni HJ, et al. A mixed methods study of zootherapy practices and associated risks for zoonotic disease spillover in Rwanda. Discover Anim. 2024 Dec 24; 1:41. doi:10.1007/s44338-024-00027-w
  • 5. Torresetti M, Peltristo B, Taddei FMJ, Di Benedetto G. Aeromonas hydrophila infection following leech therapy for the treatment of nipple–areola complex congestion after breast reduction: a case report. Arch Plast Surg. 2024 Apr;51(3):317–320. doi:10.1055/s-0043-1776696
  • 6. McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA. Determinants of mortality for necrotizing softtissue infections. Ann Surg. 1995;221(5):558–63. doi:10.1097/00000658-199505000-00013.
  • 7. Alajmi T, Aljulaihim A, Alzahrani M, Aljuhayyiam S. Necrotizing Fasciitis Following Wet Cupping: A Case Report. Am J Case Rep. 2021;22: e931462. doi:10.12659/AJCR.931462.
  • 8. Wang YH, Chen WT. Foreign body cystic granuloma and abscess after acupoint catgut embedding. J Formos Med Assoc. 2021;120(5):1140–1141. doi:10.1016/j.jfma.2021.02.002.
  • 9. Collins CM, McCarty A, Jalilvand A, et al. Outcomes of patients with necrotizing soft tissue infections: a propensity-matched analysis using the National Inpatient Sample. Surg Infect (Larchmt). 2022 Apr;23(3):304–312. doi:10.1089/sur.2021.317
  • 10. Çalbay A, Bayramoğlu A, Karadeniz E. What are the Alternatives to the LRINEC Score in Identifying Necrotizing Soft Tissue Infections in the Emergency Department? Eurasian J Crit Care. 2022 Aug;4(2):41–46. doi:10.55994/ejcc.1135938
  • 11. Zacharias N, Velmahos GC, Salama A, Alam HB, de Moya M, King DR, Novelline RA. Diagnosis of necrotizing soft tissue infections by computed tomography. Arch Surg. 2010;145(5):452–5. doi:10.1001/archsurg.2010.50.
  • 12. Martinez M, Peponis T, Hage A, Yeh DD, Kaafarani HMA, Fagenholz PJ, et al. The role of computed tomography in the diagnosis of necrotizing soft tissue infections. World J Surg. 2018;42(1):82–87. doi:10.1007/s00268-017-4145-x.
  • 13. Guliyeva RA, Baranova AY, Kartashov AV, et al. Practical review of necrotizing fasciitis: Principles and evidencebased management. J Surg Res. 2024 Jan;284:189–197. doi:10.1016/j.jss.2023.10.003.
  • 14. Prabhu S, Reddy S, Reddy S, et al. Necrotizing fasciitis: treatment concepts & clinical outcomes. J Clin Med. 2023 Jun;12(6):1832. doi:10.3390/jcm12061832.
  • 15. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jul;59(2):e10–52. doi:10.1093/cid/ciu296.
  • 16. Wei X, Huo J, Yang Q, Li J. Early diagnosis of necrotizing fasciitis: Imaging techniques and their combined application. Int Wound J. 2024 Jan;21(1):e14379. doi:10.1111/iwj.14379.
  • 17. Bilgili P, Gümüştakım RS, Cevik M, Baser DA, Doğaner A, Coşkun E, et al; AHEF BilimKurulu. Turkish primary care patients’ overviews and attitudes about traditional and complementary medicine: a cross-sectional study. Med Bull Haseki. 2023;61(4):238–246. doi:10.4274/haseki.galenos.2023.9276.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Acil Tıp
Bölüm Case Report
Yazarlar

Ali Ekber Karabulut 0000-0002-7203-1178

Burcu Özen Karabulut 0000-0002-9046-6511

Yayımlanma Tarihi 30 Eylül 2025
Gönderilme Tarihi 28 Nisan 2025
Kabul Tarihi 20 Temmuz 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 16 Sayı: 3

Kaynak Göster

APA Karabulut, A. E., & Özen Karabulut, B. (2025). From a Traditional Treatment to a Major Amputation: A Zootherapy-Induced Necrotizing Soft Tissue Infection. Journal of Emergency Medicine Case Reports, 16(3), 114-117. https://doi.org/10.33706/jemcr.1685095
AMA Karabulut AE, Özen Karabulut B. From a Traditional Treatment to a Major Amputation: A Zootherapy-Induced Necrotizing Soft Tissue Infection. Journal of Emergency Medicine Case Reports. Eylül 2025;16(3):114-117. doi:10.33706/jemcr.1685095
Chicago Karabulut, Ali Ekber, ve Burcu Özen Karabulut. “From a Traditional Treatment to a Major Amputation: A Zootherapy-Induced Necrotizing Soft Tissue Infection”. Journal of Emergency Medicine Case Reports 16, sy. 3 (Eylül 2025): 114-17. https://doi.org/10.33706/jemcr.1685095.
EndNote Karabulut AE, Özen Karabulut B (01 Eylül 2025) From a Traditional Treatment to a Major Amputation: A Zootherapy-Induced Necrotizing Soft Tissue Infection. Journal of Emergency Medicine Case Reports 16 3 114–117.
IEEE A. E. Karabulut ve B. Özen Karabulut, “From a Traditional Treatment to a Major Amputation: A Zootherapy-Induced Necrotizing Soft Tissue Infection”, Journal of Emergency Medicine Case Reports, c. 16, sy. 3, ss. 114–117, 2025, doi: 10.33706/jemcr.1685095.
ISNAD Karabulut, Ali Ekber - Özen Karabulut, Burcu. “From a Traditional Treatment to a Major Amputation: A Zootherapy-Induced Necrotizing Soft Tissue Infection”. Journal of Emergency Medicine Case Reports 16/3 (Eylül2025), 114-117. https://doi.org/10.33706/jemcr.1685095.
JAMA Karabulut AE, Özen Karabulut B. From a Traditional Treatment to a Major Amputation: A Zootherapy-Induced Necrotizing Soft Tissue Infection. Journal of Emergency Medicine Case Reports. 2025;16:114–117.
MLA Karabulut, Ali Ekber ve Burcu Özen Karabulut. “From a Traditional Treatment to a Major Amputation: A Zootherapy-Induced Necrotizing Soft Tissue Infection”. Journal of Emergency Medicine Case Reports, c. 16, sy. 3, 2025, ss. 114-7, doi:10.33706/jemcr.1685095.
Vancouver Karabulut AE, Özen Karabulut B. From a Traditional Treatment to a Major Amputation: A Zootherapy-Induced Necrotizing Soft Tissue Infection. Journal of Emergency Medicine Case Reports. 2025;16(3):114-7.