Schmidt J, Dogan N, Schäfer M
Chirurgische Klinik I, Evangelisches Krankenhaus Lutherhaus, Essen.
Dtsch Med Wochenschr. 2006 Mar 3;131(9):430-3. doi: 10.1055/s-2006-932537.
A man aged 62 was hospitalized for treatment of an axillary abscesses originating from a suppurative hidradenitis.
Microbiological tests revealed peptostreptococcus and staphylococci. Hepatic enzymes were moderately elevated in association with a mild hyperbilirubinemia.
After surgical intervention the patient developed a severe septic illness together with a unilateral pulmonary infection and abscess formation, requiring a thoracotomy. Preoperative serology ruled out active hepatitis as well as atypical pneumonia. The detection of a unilateral septic axillary thrombosis led to the correct diagnosis. Antibiotics and anticoagulation brought about a complete cure.
In cases of septicemia of uncertain origin septic venous thromboses should be considered in the differential diagnosis.
一名62岁男性因治疗源自化脓性汗腺炎的腋窝脓肿而住院。
微生物学检测发现消化链球菌和葡萄球菌。肝酶中度升高并伴有轻度高胆红素血症。
手术干预后，患者出现严重败血症，伴有单侧肺部感染和脓肿形成，需要进行开胸手术。术前血清学检查排除了活动性肝炎和非典型肺炎。单侧化脓性腋窝血栓形成的检测得出了正确诊断。抗生素和抗凝治疗实现了完全治愈。
在病因不明的败血症病例中，鉴别诊断时应考虑脓毒性静脉血栓形成。
