Department of Pathology, Eye Pathology Section, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Acta Ophthalmol. 2020 Mar;98(2):207-212. doi: 10.1111/aos.14205. Epub 2019 Jul 29.
Necrotizing soft tissue infection, also known as necrotizing fasciitis (NF), is a fast-spreading life-threatening infection that most commonly affects the lower limbs, groin, or abdomen. Periocular necrotizing fasciitis (PNF) is rare. Limited data exist on PNF immune cell subset; hence, this study aims to determine the representation of immune cell subsets in patients diagnosed with PNF using immunohistochemical stainings.
All patients diagnosed with PNF at Copenhagen University Hospital from 2008 to 2018 were included. Their electronic medical records and pathology reports were assessed, and available tissue specimens were reviewed and stained with monoclonal antibodies for CD1a Langerhans' cells, CD3 T lymphocytes, CD15 granulocytes, CD44 lymphohematopoietic cells, CD68 histiocytes, CD79α B lymphocytes, and FXIIIa+ dendritic macrophages and Langerhans' cells. The number of positive cells was counted, and an average score was calculated. The location of immune cells and bacteria was assessed.
The specimens were characterized by acute inflammation and necrosis of the fascia, while striated muscle involvement was less frequent. Haemolytic group A streptococci and Staphylococcus aureus were identified and mainly located in the deep dermis and subcutis in close relation to the fascia. Only few areas harboured both bacteria and inflammatory cells. Granulocytes, histiocytes and CD44 lymphohematopoietic cells were demonstrated to be abundant in all patients, while B and T lymphocytes, dendritic macrophages and Langerhans' cells were less frequent.
The immune cell subsets found in this study of PNF were consistent with those identified in the literature on NF in other anatomical locations. This study concludes that immune cells are abundant and exhibit a typical pattern in PNF.
坏死性软组织感染，也称为坏死性筋膜炎（NF），是一种快速传播的危及生命的感染，最常影响下肢、腹股沟或腹部。眼周坏死性筋膜炎（PNF）很少见。关于 PNF 免疫细胞亚群的数据有限；因此，本研究旨在使用免疫组织化学染色确定诊断为 PNF 的患者的免疫细胞亚群的代表性。
本研究纳入了 2008 年至 2018 年期间在哥本哈根大学医院诊断为 PNF 的所有患者。评估了他们的电子病历和病理报告，并对可用的组织标本进行了复习，并使用针对 CD1a 朗格汉斯细胞、CD3 T 淋巴细胞、CD15 粒细胞、CD44 淋巴造血细胞、CD68 组织细胞、CD79α B 淋巴细胞和 FXIIIa+树突状巨噬细胞和朗格汉斯细胞的单克隆抗体进行染色。计算阳性细胞的数量，并计算平均评分。评估免疫细胞和细菌的位置。
标本的特征是筋膜的急性炎症和坏死，而横纹肌受累较少。鉴定出溶血性 A 组链球菌和金黄色葡萄球菌，主要位于真皮和皮下组织的深部，与筋膜紧密相关。只有少数区域同时存在细菌和炎症细胞。所有患者均表现出大量粒细胞、组织细胞和 CD44 淋巴造血细胞，而 B 和 T 淋巴细胞、树突状巨噬细胞和朗格汉斯细胞则较少。
本研究中 PNF 的免疫细胞亚群与文献中其他解剖部位 NF 的免疫细胞亚群一致。本研究得出结论，免疫细胞在 PNF 中丰富，并表现出典型的模式。
