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一例乳腺原发性坏死性筋膜炎的病例报告:一种罕见但致命的疾病,需要迅速进行手术治疗。

A case report of primary necrotising fasciitis of the breast: A rare but deadly entity requiring rapid surgical management.

作者信息

Fayman Kimberley, Wang Kejia, Curran Richard

机构信息

Blacktown Hospital, NSW, Australia.

University of New South Wales, NSW, Australia.

出版信息

Int J Surg Case Rep. 2017;31:221-224. doi: 10.1016/j.ijscr.2017.01.049. Epub 2017 Jan 23.

Abstract

INTRODUCTION

Necrotising fasciitis of the breast is a rare entity with very few cases reported in the literature. It is rapidly progressive and can lead to sepsis and multi-organ failure without prompt medical and surgical management.

PRESENTATION OF CASE

We describe a case of a non-diabetic 23-year-old female with primary necrotising fasciitis of the right breast. She presented in septic shock with gross breast discolouration and nipple discharge. Immediate resuscitation followed by muscle-sparing mastectomy within 3h of her presentation was performed. She was managed postoperatively in intensive care. Complications included myocardial infarction and anuria requiring continuous renal replacement therapy. She eventually recovered with close to normal cardiac function and was discharged home after skin grafting of her mastectomy wound.

CONCLUSION

This is the youngest patient with primary necrotising fasciitis of the breast described in the literature. Prompt resuscitation and an aggressive surgical approach are critical to the successful management of this life threatening pathology.

摘要

引言

乳腺坏死性筋膜炎是一种罕见疾病,文献报道的病例极少。它进展迅速,若不及时进行药物和手术治疗,可导致败血症和多器官功能衰竭。

病例介绍

我们描述了一例23岁非糖尿病女性原发性右乳腺坏死性筋膜炎的病例。她以感染性休克就诊,乳房明显变色且有乳头溢液。就诊后立即进行复苏,并在3小时内进行了保留肌肉的乳房切除术。术后在重症监护室进行管理。并发症包括心肌梗死和无尿,需要持续肾脏替代治疗。她最终康复,心脏功能接近正常,乳房切除伤口植皮后出院回家。

结论

这是文献中报道的最年轻的原发性乳腺坏死性筋膜炎患者。迅速复苏和积极的手术方法对于成功治疗这种危及生命的疾病至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c15e/5304239/9ff0eb2f115a/gr1.jpg

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