From Whittington Health, London, United Kingdom.
Exp Clin Transplant. 2020 Aug;18(4):519-521. doi: 10.6002/ect.2018.0316. Epub 2019 Jan 21.
Necrotizing fasciitis is a devastating, rapidly pro-gressive soft tissue infection. We present an unusual case of Escherichia coli necrotizing fasciitis following renal transplant. The patient was a 50-year-old woman previously on long-term hemodialysis who presented with left thigh erythema adjacent to the site of a central venous catheter 5 days after renal transplant. The classical features of necrotizing fasciitis were initially absent, and, despite aggressive resuscitation and debridement, she did not survive. Monomicrobial E. coli necrotizing fasciitis is rare, especially in this cohort of patients. Immunosuppression is a known risk factor for infection, and patients may present atypically. Shock and erythema may be the only clues to infection. Necrotizing fasciitis must be considered in acutely unwell renal transplant recipients so that immediate and life-saving surgical debridement can be delivered.
坏死性筋膜炎是一种具有破坏性且迅速进展的软组织感染。我们报告了一例肾移植术后大肠埃希菌坏死性筋膜炎的罕见病例。该患者为一名 50 岁女性，长期接受血液透析，肾移植后 5 天出现左大腿紧邻中心静脉导管部位的红斑。最初并未出现坏死性筋膜炎的典型特征，尽管进行了积极的复苏和清创，她最终仍未能幸存。单一微生物的大肠埃希菌坏死性筋膜炎较为罕见，尤其是在该患者群体中。免疫抑制是感染的已知危险因素，患者可能表现出非典型症状。休克和红斑可能是感染的唯一线索。对于急性不适的肾移植受者，必须考虑坏死性筋膜炎的可能性，以便及时进行挽救生命的手术清创。
