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巴氏腺脓肿手术治疗继发会阴部坏死性筋膜炎

[Necrotizing fasciitis of the perineum secondary to a surgical treatment of Bartholin's gland abscess].

作者信息

Kdous M, Hachicha R, Iraqui Y, Jacob D, Piquet P-M, Truc J-B

机构信息

Service de gynécologie-obstétrique, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.

出版信息

Gynecol Obstet Fertil. 2005 Nov;33(11):887-90. doi: 10.1016/j.gyobfe.2005.06.022. Epub 2005 Oct 21.

Abstract

Necrotizing fasciitis of the perineum is a rare but of fast evolution, and potentially fatal infectious disease process. It is characterized by progressive inflammation and extensive necrosis of subcutaneous tissue involving the fascia and other adjacent tissues. This infection may be idiopathic or secondary to local trauma or pelvic surgery. Its mortality rate is 20%. We report a case of necrotzing fasciitis of the perineum in a 34-year-old woman following incision and drainage of Bartholin's gland abscess. Streptococcus A, Proteus mirabilis, Escherichia coli, and Candida albicans were isolated. Intravenous broad spectrum antibiotic therapy was promptly instituted. Concurrent surgical debridement of all necrotic areas was required. Post debridement therapy required a long period of dressing changes until cicatrisation. Necrotizing fasciitis of the perineum is a surgical emergency. Early diagnosis and prompt aggressive debridement are the keys to successful management.

摘要

会阴坏死性筋膜炎是一种罕见但进展迅速且可能致命的感染性疾病过程。其特征为皮下组织进行性炎症和广泛坏死,累及筋膜及其他相邻组织。这种感染可能是特发性的,也可能继发于局部创伤或盆腔手术。其死亡率为20%。我们报告一例34岁女性在巴氏腺脓肿切开引流后发生会阴坏死性筋膜炎的病例。分离出了A群链球菌、奇异变形杆菌、大肠杆菌和白色念珠菌。立即开始静脉注射广谱抗生素治疗。同时需要对所有坏死区域进行手术清创。清创后治疗需要长时间更换敷料直至愈合。会阴坏死性筋膜炎是一种外科急症。早期诊断和及时积极清创是成功治疗的关键。

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