Ward Nicholas D, Harris Jennifer W, Sloan David A
Graduate Medical Education - General Surgery Residency Program, University of Kentucky, Lexington, Kentucky.
Department of Surgery, Section of Endocrine Surgery, University of Kentucky, Lexington, Kentucky.
Breast J. 2017 Jan;23(1):95-99. doi: 10.1111/tbj.12686. Epub 2016 Sep 16.
Necrotizing fasciitis is a rare, aggressive, soft-tissue infection that results in necrosis of skin, subcutaneous tissue, and fascia. It spreads rapidly and may progress to sepsis, multi-organ failure, and death. Predisposing conditions include diabetes, chronic alcoholism, advanced age, vascular disease, and immunosuppression and many cases are preceded by an injury or invasive procedure. Necrotizing soft-tissue infection of the breast is uncommon, with only a few reported cases in the literature. We present a 53-year-old diabetic woman who presented to the emergency room with several weeks of worsening breast and shoulder pain, swelling, and erythema. Upon formal evaluation by the surgical service, a necrotizing soft-tissue infection was suspected, and the patient was scheduled for emergent, surgical debridement. Because of the aggressive nature and high mortality of this disease, immediate surgical intervention, coupled with antibiotic therapy and physiologic support, is necessary to prevent complications and death.
坏死性筋膜炎是一种罕见的、侵袭性的软组织感染，可导致皮肤、皮下组织和筋膜坏死。它传播迅速，可能进展为脓毒症、多器官功能衰竭和死亡。易感因素包括糖尿病、慢性酒精中毒、高龄、血管疾病和免疫抑制，许多病例在发病前有受伤或侵入性操作史。乳腺坏死性软组织感染并不常见，文献中仅有少数病例报道。我们报告一例53岁的糖尿病女性患者，因乳房和肩部疼痛、肿胀及红斑数周加重而就诊于急诊室。经外科评估，怀疑为坏死性软组织感染，该患者被安排紧急进行外科清创术。鉴于这种疾病的侵袭性和高死亡率，立即进行手术干预，联合抗生素治疗和生理支持，对于预防并发症和死亡是必要的。
