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一名多发伤患者切开复位内固定术后发生致命性坏死性筋膜炎

Fatal Necrotizing Fasciitis following Open Reduction Internal Fixation in a Polytrauma Patient.

作者信息

Nehme Alexandre, Joukhadar Nabih I, Saidy Elias, Darwiche Mohammad, Aouad Dany K, Abdel Nour Hicham G

机构信息

Department of Orthopedic Surgery and Traumatology, Saint Georges University Medical Center, Balamand University, P.O. Box 166378, Achrafieh, Beirut 1100 2807, Lebanon.

出版信息

Case Rep Infect Dis. 2018 Jun 21;2018:4176320. doi: 10.1155/2018/4176320. eCollection 2018.

Abstract

Necrotizing fasciitis is an uncommon and potentially fatal infection that can affect the epidermis, dermis, and more commonly the subcutaneous, fascia, and muscle layers. NF is usually caused by toxin-producing bacteria with a relatively fast progression associated with severe surrounding tissue destruction. Early diagnosis and management are crucial factors for survival. Broad-spectrum antibiotics along with surgical debridement, sometimes multiple, are needed in order to stop or slow down the progression of NF. Despite optimal care, necrotizing fasciitis remains a highly morbid condition with a high mortality rate. We present a case of a 28-year-old male patient with rapidly developing fatal associated with necrotizing fasciitis, after open reduction and internal fixation (ORIF) of multiple fractures after polytrauma.

摘要

坏死性筋膜炎是一种罕见且可能致命的感染,可累及表皮、真皮,更常见的是皮下组织、筋膜和肌肉层。坏死性筋膜炎通常由产毒素细菌引起,进展相对较快,伴有严重的周围组织破坏。早期诊断和治疗是生存的关键因素。需要使用广谱抗生素并进行手术清创,有时需要多次清创,以阻止或减缓坏死性筋膜炎的进展。尽管给予了最佳治疗,但坏死性筋膜炎仍然是一种高发病率、高死亡率的疾病。我们报告一例28岁男性患者,在多发伤后多处骨折切开复位内固定(ORIF)术后,迅速发展为与坏死性筋膜炎相关的致命病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb9f/6033253/32c64746ba41/CRIID2018-4176320.001.jpg

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