Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, Maryland.
Department of Orthopaedics, Naval Medical Center San Diego, San Diego, California.
JBJS Case Connect. 2020 Jan-Mar;10(1):e0152. doi: 10.2106/JBJS.CC.19.00152.
An immunocompetent 43-year-old man was diagnosed with necrotizing fasciitis of his forearm. Despite receiving appropriate treatment, his clinical condition continued to deteriorate. Further evaluation revealed subsequent proliferation of the infection to multiple noncontiguous areas of the body consistent with a rare condition known as synchronous multifocal necrotizing fasciitis. Prompt identification, followed by serial debridements of all affected areas, ultimately saved the patient's life.
This unusual multifocal presentation of necrotizing fasciitis can produce diagnostic uncertainty and delay life-saving treatment. Early recognition, followed by prompt treatment, is paramount for reducing morbidity and mortality associated with this devastating infection.
一名免疫功能正常的 43 岁男性被诊断患有前臂坏死性筋膜炎。尽管接受了适当的治疗,但他的临床状况仍持续恶化。进一步评估显示,感染随后扩散到身体多个非连续区域,符合一种罕见疾病,即同步多灶性坏死性筋膜炎。及时识别并随后对所有受影响区域进行连续清创,最终挽救了患者的生命。
坏死性筋膜炎这种不常见的多灶性表现可能会导致诊断不确定并延迟救命治疗。早期识别,随后及时治疗,对于降低与这种破坏性感染相关的发病率和死亡率至关重要。