Determann Catherine, Walker Craig Andrew
Department of Anaesthetics & Critical Care, NHS Lothian, Edinburgh, Midlothian, UK.
BMJ Case Rep. 2013 Oct 9;2013:bcr2013200242. doi: 10.1136/bcr-2013-200242.
A patient admitted to the intensive care unit for management of hypotension following a multiple medications overdose subsequently deteriorated rapidly with sepsis. A cannula site was noted to be bruised, swollen and erythematous and the X-ray demonstrated gas sitting within the tissues surrounding the metacarpal bones. The patient was referred to the orthopaedic surgeons and quickly taken for debridement of the affected area and fasciotomies of the forearm. Microbiological investigation confirmed Clostridium perfringens to be present in multiple fluid samples taken from the affected site.
一名因多种药物过量导致低血压而入住重症监护病房的患者,随后因败血症迅速恶化。发现插管部位有瘀伤、肿胀和红斑,X线显示掌骨周围组织内有气体。患者被转诊至骨科医生处,并迅速接受了受影响区域的清创术和前臂筋膜切开术。微生物学调查证实,从受影响部位采集的多个液体样本中存在产气荚膜梭菌。