Brook Itzhak
Georgetown University, Schools of Medicine, 4431 Albemarle st NW, Washington, DC 20016, USA.
Int J Surg. 2008 Aug;6(4):328-38. doi: 10.1016/j.ijsu.2007.07.001. Epub 2007 Jul 15.
This review summarizes the microbiological aspects and management of soft tissue and muscle infections. The infections presented are: impetigo, folliculitis, furunculosis and carbuncles, cellulitis, erysipelas, infectious gangrene (includes necrotizing fasciitis or streptococcal gangrene, gas gangrene or clostridium myonecrosis, anaerobic cellulites, progressive bacterial synergistic gangrene, synergistic necrotizing cellulitis or perineal phlegmon, gangrenous balanitis, and gangrenous cellulitis in the immunocompromised patient), secondary bacterial infections complication skin lesions, diabetic and other chronic superficial skin ulcers and subcutaneous abscesses and myositis. These infections often occur in body sites or in those that have been compromised or injured by foreign body, trauma, ischemia, malignancy or surgery. In addition to Group A streptococci and Staphylococcus aureus, the indigenous aerobic and anaerobic cutaneous and mucous membranes local microflora usually is responsible for polymicrobial infections. These infections may occasionally lead to serious potentially life-threatening local and systemic complications. The infections can progress rapidly and early recognition and proper medical and surgical management is the cornerstone of therapy.
本综述总结了软组织和肌肉感染的微生物学方面及管理。所呈现的感染包括：脓疱病、毛囊炎、疖病和痈、蜂窝织炎、丹毒、感染性坏疽（包括坏死性筋膜炎或链球菌性坏疽、气性坏疽或梭菌性肌坏死、厌氧性蜂窝织炎、进行性细菌性协同性坏疽、协同性坏死性蜂窝织炎或会阴部蜂窝织炎、坏疽性龟头炎以及免疫功能低下患者的坏疽性蜂窝织炎）、继发性细菌感染并发皮肤病变、糖尿病及其他慢性浅表皮肤溃疡、皮下脓肿和肌炎。这些感染常发生于身体部位或已因异物、创伤、缺血、恶性肿瘤或手术而受损的部位。除A组链球菌和金黄色葡萄球菌外，皮肤和黏膜的固有需氧和厌氧局部微生物群通常是多微生物感染的病因。这些感染偶尔可能导致严重的、潜在危及生命的局部和全身并发症。感染可迅速进展，早期识别以及恰当的药物和手术管理是治疗的基石。
