Torrejón Maria Del Carmen, Celi Edgardo, Cancho David, Knox Ailie, Henriquez-Camacho Cesar
Department of Trauma and Orthopedics, Hospital Universitario Fundacion Alcorcon, Calle Budapest 1, 28922 Madrid, Spain.
Department of Surgery, Hospital Universitario Fundacion Alcorcon, Calle Budapest 1, 28922 Madrid, Spain.
Case Rep Emerg Med. 2014;2014:685263. doi: 10.1155/2014/685263. Epub 2014 Jun 9.
We report a case of fatal necrotizing soft tissue infection (NSTI) due to Clostridium perfringens (CP) in a neutropenic patient with diabetes mellitus. As in many cases, by the time a diagnosis was made, the condition had rapidly progressed to its late stages, resulting in a fatal outcome. The emergency physician should be aware of NSTI as a complication when patients present with pain out of proportion to physical findings and/or signs of soft tissue compromise. Negative prognostic factors for survival are diabetes mellitus, immunosuppression, age, and toxic shock syndrome. A bedside ultrasound scan allows for rapid evaluation in time-sensitive critically ill patients and can promote prompt treatment without the need to delay for further imaging studies.
我们报告了一例因产气荚膜梭菌（CP）引起的致命性坏死性软组织感染（NSTI），患者为一名患有糖尿病的中性粒细胞减少症患者。与许多病例一样，在做出诊断时，病情已迅速发展到晚期，导致了致命的结果。当患者出现疼痛与体格检查结果不成比例和/或有软组织受损迹象时，急诊医生应意识到NSTI是一种并发症。生存的负面预后因素包括糖尿病、免疫抑制、年龄和中毒性休克综合征。床边超声扫描可为时间紧迫的重症患者提供快速评估，并可促进及时治疗，而无需等待进一步的影像学检查。
