Liu Chung-Te, Chen Yen-Cheng, Chen Tso-Hsiao, Ou Tsong-Yih
Division of Nephrology, Department of Medicine, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.
Hemodial Int. 2012 Oct;16(4):564-7. doi: 10.1111/j.1542-4758.2011.00658.x. Epub 2012 Feb 3.
Necrotizing fasciitis is a lethal soft tissue infection for its rapid progression to septic shock. We present a 59-year-old male on chronic hemodialysis (HD). We made the diagnosis of necrotizing fasciitis of the right thigh due to the crepitus from physical examination and subcutaneous emphysema from an X film. He was successfully treated with antibiotics and surgical debridement. The blood and surgical drainage cultures showed Escherichia coli, which is less commonly seen in cutaneous infection. The colonoscopic finding revealed adenomatous polyps. Necrotizing fasciitis in patients on HD requires early diagnosis and aggressive treatment to ensure the favorable clinical outcomes.
坏死性筋膜炎是一种致命的软组织感染，因其可迅速发展为感染性休克。我们报告一例59岁接受慢性血液透析（HD）的男性患者。通过体格检查触及捻发音及X线显示皮下气肿，我们诊断为右大腿坏死性筋膜炎。患者经抗生素及手术清创治疗成功。血液及手术引流培养显示为大肠杆菌，这在皮肤感染中较少见。结肠镜检查发现腺瘤性息肉。接受HD治疗的患者发生坏死性筋膜炎需要早期诊断及积极治疗以确保良好的临床结局。
