Wong C-H, Kurup A, Wang Y-S, Heng K-S, Tan K-C
Department of Plastic Surgery, Singapore General Hospital, Outram Road, Singapore, Singapore, 169608.
Eur J Clin Microbiol Infect Dis. 2004 May;23(5):403-7. doi: 10.1007/s10096-004-1125-5. Epub 2004 Apr 27.
Presented here are four cases of necrotizing fasciitis caused by Klebsiella spp. that were treated at one hospital over a 2-year period. Klebsiella necrotizing fasciitis can occur via direct inoculation, local trauma or, more commonly, hematogenous spread from other septic foci. Early, aggressive, surgical debridement and appropriate antimicrobial treatment are the cornerstones of treatment for this condition. Necrotizing fasciitis due to Klebsiella spp. is unique in that it is commonly associated with multiple septic foci. While liver abscesses and endogenous endophthalmitis are better-known associations of disseminated Klebsiella infection, necrotizing fasciitis is increasingly recognized as one of the manifestations of this syndrome. When treating Klebsiella necrotizing fasciitis, awareness of the potential for multiorgan involvement should prompt a thorough search for associated foci of infection.
本文介绍了一家医院在两年时间内收治的4例由克雷伯菌属引起的坏死性筋膜炎病例。克雷伯菌坏死性筋膜炎可通过直接接种、局部创伤引起，或更常见的是由其他感染灶血行播散所致。早期积极的手术清创和适当的抗菌治疗是这种疾病治疗的基石。由克雷伯菌属引起的坏死性筋膜炎的独特之处在于它通常与多个感染灶相关。虽然肝脓肿和内源性眼内炎是播散性克雷伯菌感染更常见的关联病症，但坏死性筋膜炎越来越被认为是该综合征的表现之一。在治疗克雷伯菌坏死性筋膜炎时，意识到多器官受累的可能性应促使对相关感染灶进行全面检查。
