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西半球辐射后肺炎克雷伯菌相关性坏死性筋膜炎:一种罕见但危及生命的临床病症。

Postirradiation Klebsiella pneumoniae-associated necrotizing fasciitis in the western hemisphere: a rare but life-threatening clinical entity.

作者信息

Kelesidis Theodoros, Tsiodras Sotirios

机构信息

Department of Medicine, Caritas St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02135, USA.

出版信息

Am J Med Sci. 2009 Sep;338(3):217-24. doi: 10.1097/MAJ.0b013e3181a393a4.

Abstract

Necrotizing fasciitis (NF) caused by Klebsiella spp. is a unique entity, particularly, in Asia, where virulent strains of Klebsiella predominate. It is now clear that Klebsiella spp. are capable of causing NF either isolated or in the context of disseminated disease. We present a unique case of NF caused by Klebsiella pneumoniae in the Western hemisphere after radiotherapy in a hospitalized patient with significant comorbidities. Physicians should be aware of nosocomially acquired K. pneumoniae fasciitis after radiotherapy in the setting of chronic comorbidities, such as diabetes and malignancy. Early diagnosis, surgical intervention, and appropriate empirical antibiotics are essential for a favorable outcome in such rare but life-threatening cases of NF.

摘要

由克雷伯菌属引起的坏死性筋膜炎(NF)是一种独特的病症,尤其是在亚洲,这里以毒性较强的克雷伯菌菌株为主。现在已经明确,克雷伯菌属能够单独引起NF,也可在播散性疾病的情况下引发。我们报告了一例在西半球发生的由肺炎克雷伯菌引起的NF的独特病例,该病例发生在一名患有严重合并症的住院患者放疗后。医生应意识到在慢性合并症(如糖尿病和恶性肿瘤)背景下放疗后医院获得性肺炎克雷伯菌性筋膜炎的情况。对于这种罕见但危及生命的NF病例,早期诊断、手术干预和适当的经验性抗生素治疗对于取得良好预后至关重要。

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