Yoshii Yuichi, Ishii Tomoo, Sakai Shinsuke
Department of Orthopaedic Surgery, Tokyo Medical University, Ibaraki Medical Center, Ibaraki 300-0395, Japan , Endowed Department of Human Resources Development for Community Medicine, Tokyo Medical University, Ibaraki Medical Center, Ibaraki 300-0395, Japan.
Hand Surg. 2013;18(2):243-6. doi: 10.1142/S021881041372012X.
Necrotising soft tissue infection is a rare and rapid process with devastating consequence. We report one case of necrotising soft tissue infection in a bilateral upper limb with uncommon oral bacteria. Radiological imaging revealed the presence of gas in upper limb soft tissues, and an MRI showed the localised signal changes in the biceps muscle of the right upper arm, and the subcutaneous tissue of the left elbow. The patient was treated with surgical resection of the infected muscle and wide debridement of the subcutaneous tissue. Antibiotics were initiated. The patient recovered immediately without functional deficit. The unique features of this patient were possible to observe in the progression of the necrotising soft tissue infection in the bilateral upper limb with intentional injection of oral bacteria, and the effect of biceps brachii resection in a prime age worker.
坏死性软组织感染是一种罕见且进展迅速的疾病,后果严重。我们报告一例双侧上肢坏死性软组织感染病例,感染菌为罕见的口腔细菌。影像学检查显示上肢软组织内有气体,磁共振成像(MRI)显示右上臂肱二头肌及左肘部皮下组织有局部信号改变。患者接受了感染肌肉的手术切除及皮下组织的广泛清创,并开始使用抗生素治疗。患者立即康复,未遗留功能障碍。该病例的独特之处在于,通过故意注射口腔细菌,观察到了双侧上肢坏死性软组织感染的进展情况,以及在一名青壮年工人身上进行肱二头肌切除的效果。