Auditory Group, Newcastle University, Institute of Neuroscience, Medical School, Newcastle upon Tyne, Tyne and Wear NE1 4LP, UK.
Age Ageing. 2013 Mar;42(2):266-8. doi: 10.1093/ageing/afs198. Epub 2013 Jan 11.
We report the case of a 97-year-old woman who had a prolonged hospital admission for the treatment of right-sided heart failure. During her stay she experienced a rapid deterioration, characterised by shortness of breath, cardiovascular compromise and a hot, red, swollen calf. Post-mortem examination demonstrated that this was caused by necrotising fasciitis due to Serratia marcescens as a single pathogen. This is only the second reported case of this condition in the absence of diabetes or immunosuppression, and clinical deterioration was much more rapid. The case underlines the importance of circumspection and regular review in the diagnosis of the elderly patient. It reminds us that these patients should be viewed as functionally immunosuppressed, and that some or all of the haematological markers of infection can be absent even in severe disease.
我们报告了一例 97 岁女性的病例，她因右侧心力衰竭而住院治疗时间较长。在住院期间，她的病情迅速恶化，表现为呼吸急促、心血管功能受损以及小腿红肿热痛。尸检显示，这是由单一致病菌粘质沙雷氏菌引起的坏死性筋膜炎所致。这是无糖尿病或免疫抑制情况下该病症的第二例报告病例，且临床恶化速度更快。该病例强调了在老年患者的诊断中保持谨慎和定期复查的重要性。它提醒我们，这些患者应被视为功能性免疫抑制，即使在严重疾病中，某些或所有感染的血液学标志物也可能缺失。
