159.2 📚 國考版

159.2.0.1 必背 — Gas Gangrene Cardinal

• Disproportionate pain + bronze/dusky skin + bullae + crepitus + 急 toxicity
• X-ray gas in muscle → 立即 surgical consult
• Don’t wait for culture — empirical immediately

159.2.0.2 必背 — 治療

• Emergent debridement > antibiotic
• PCN G + Clindamycin (toxin suppress, ribosome)
• ± HBO
• ICU resus

159.2.0.3 必背 — C. septicum

• Spontaneous myonecrosis = occult GI malignancy (大腸癌, leukemia)
• 必查 colonoscopy

159.2.0.4 必背 — C. perfringens Food Poisoning

• 8-16 hr 潛伏, watery diarrhea, no vomit/fever
• 無 antibiotic

159.2.0.5 必背 — C. sordellii TSS-like

• Post-partum, post-abortion, mifepristone, IDU
• No fever, no rash, refractory shock, leukemoid rxn
• Mortality 80%

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