Schade Valerie L, Roukis Thomas S, Haque Mohamad
Limb Preservation Complex Lower Extremity Surgery, Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA.
J Foot Ankle Surg. 2010 Mar-Apr;49(2):159.e1-8. doi: 10.1053/j.jfas.2009.06.007. Epub 2009 Nov 27.
Clostridium septicum accounts for 1% of all reported clostridial infections. C septicum infections are most often nontraumatic in nature and associated with either an occult colonic or hematologic malignancy. The initial presentation of a C septicum infection can be relatively benign with rapid progression to fatality without emergent treatment. Presented is a case of necrotizing fasciitis of the forefoot caused by C septicum associated with an occult adenocarcinoma of the colon in a patient with uncontrolled diabetes. The process we used to achieve successful functional limb preservation based on rapid surgical intervention and use of a multidisciplinary approach to medical and surgical management of this patient is discussed in detail, as well as a through review of the literature regarding the association between malignancies and C septicum infections.
败血梭菌占所有报告的梭菌感染的1%。败血梭菌感染本质上大多是非创伤性的，且与隐匿性结肠或血液系统恶性肿瘤相关。败血梭菌感染的初始表现可能相对良性，但如果不进行紧急治疗，会迅速进展至死亡。本文介绍了一例由败血梭菌引起的前足坏死性筋膜炎病例，该病例发生在一名患有未控制糖尿病且伴有隐匿性结肠腺癌的患者身上。详细讨论了我们基于快速手术干预以及采用多学科方法对该患者进行医疗和手术管理从而成功保留肢体功能的过程，同时还全面回顾了关于恶性肿瘤与败血梭菌感染之间关联的文献。
