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肺炎链球菌相关坏死性筋膜炎病例报告

Case Report of Necrotizing Fasciitis Associated with Streptococcus pneumoniae.

作者信息

Jiao Lei, Chagla Zain, Kaki Reham Mohammedsaeed, Gohla Gabriela, Smieja Marek

机构信息

Medical Microbiology Postgraduate Training Program, Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada L8S 4L8.

St. Joseph Healthcare and Hamilton Health Sciences, Hamilton, ON, Canada L8N 1Y2; Department of Medicine, McMaster University, Hamilton, ON, Canada L8S 4L8.

出版信息

Can J Infect Dis Med Microbiol. 2016;2016:6872739. doi: 10.1155/2016/6872739. Epub 2016 Mar 30.

Abstract

Necrotizing fasciitis, caused by Streptococcus pneumoniae, is an extremely rare and life-threatening bacterial soft tissue infection. We report a case of early necrotizing fasciitis associated with Streptococcus pneumoniae infection in a 26-year-old man who was immunocompromised with mixed connective tissue disease. The patient presented with acute, painful, erythematous, and edematous skin lesions of his right lower back, which rapidly progressed to the right knee. The patient underwent surgical exploration, and a diagnosis of necrotizing fasciitis was confirmed by pathological evidence of necrosis of the fascia and neutrophil infiltration in tissue biopsies. Cultures of fascial tissue biopsies and blood samples were positive for Streptococcus pneumoniae. To our knowledge, this is the first report of necrotizing fasciitis resulting from Streptococcus pneumoniae diagnosed at early phase; the patient recovered well without surgical debridement.

摘要

由肺炎链球菌引起的坏死性筋膜炎是一种极其罕见且危及生命的细菌性软组织感染。我们报告一例26岁患有混合性结缔组织病且免疫功能低下的男性患者,其早期坏死性筋膜炎与肺炎链球菌感染相关。患者右下腹出现急性、疼痛、红斑性及水肿性皮肤病变,并迅速蔓延至右膝。患者接受了手术探查,组织活检中筋膜坏死和中性粒细胞浸润的病理证据证实了坏死性筋膜炎的诊断。筋膜组织活检和血样培养均显示肺炎链球菌呈阳性。据我们所知,这是首例早期诊断的由肺炎链球菌引起的坏死性筋膜炎病例;该患者未经手术清创即恢复良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e4c/4904562/4deea89e19fe/CJIDMM2016-6872739.001.jpg

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