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下肢软组织损伤并发Ⅱ型坏死性筋膜炎,凸显了敏锐临床实践和恰当治疗的必要性。

Soft tissue injury of the lower extremity complicated by type II necrotising fasciitis highlighting the need for astute clinical practices and proper treatment.

作者信息

Sabre Alexander, Robles Carlos G, Krisar-White Patricia, Farricielli Laurie

机构信息

Universidad Autonoma De Guadalajara Medical School, Guadalajara, Mexico.

University of Medicine and Pharmacy Iuliu, Cluj-Napoca, Romania.

出版信息

BMJ Case Rep. 2014 Jun 27;2014:bcr2014204720. doi: 10.1136/bcr-2014-204720.

Abstract

Necrotising fasciitis (NF) is a soft tissue bacterial-derived infection characterised clinically by fulminant tissue destruction of the poorly blood-supplied muscle fascia and overlying subcutaneous fat. Although these infections first appear as minor superficial manifestations, they are capricious in nature and often lead to sepsis, organ failure and high mortality. We report a case of type II necrotising fasciitis in a 39-year-old Caucasian female patient who presented to the emergency department with cellulitis of her right foot and lower leg that rapidly developed into tissue necrosis. The patient course is of unique interest due to progressive history over a 104 days time frame with complications following surgical treatments and outpatient follow-up. We highlight the importance of early detection and pertinent clinical awareness from a wide range of medical specialties that were involved in this case, and how this process is critical, in order to properly diagnose and treat NF-derived tissue infections.

摘要

坏死性筋膜炎(NF)是一种由细菌引起的软组织感染,临床上的特征是血液供应较差的肌肉筋膜和覆盖其上的皮下脂肪发生暴发性组织破坏。尽管这些感染最初表现为轻微的浅表症状,但它们性质多变,常导致败血症、器官衰竭和高死亡率。我们报告一例39岁的白种女性患者的II型坏死性筋膜炎病例,该患者因右脚和小腿蜂窝织炎就诊于急诊科,随后迅速发展为组织坏死。由于在104天的时间范围内病情不断进展,且手术治疗和门诊随访后出现并发症,该患者的病程具有独特的研究价值。我们强调了早期检测以及参与该病例的多个医学专科的相关临床意识的重要性,以及这一过程对于正确诊断和治疗NF所致组织感染的关键作用。

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本文引用的文献

1
Nosocomial transmission of necrotising fasciitis.坏死性筋膜炎的医院内传播
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Streptococcal infections of skin and soft tissues.皮肤和软组织的链球菌感染
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Clinical and microbiological features of necrotizing fasciitis.坏死性筋膜炎的临床和微生物学特征。
J Clin Microbiol. 1995 Sep;33(9):2382-7. doi: 10.1128/jcm.33.9.2382-2387.1995.

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