Kampouri Eleftheria, Filippidis Paraskevas, Lhopitallier Loïc, Pham Truong-Thanh, Schuhler Caroline, Toutous Trellu Laurence, Mombelli Matteo, Huttner Benedikt
Service des maladies infectieuses, CHUV, 1011 Lausanne.
Service des maladies infectieuses, HUG, 1211 Genève.
Rev Med Suisse. 2020 Apr 15;16(690):732-738.
Skin infections are a frequent cause of consultation, yet the diagnosis can be challenging for physicians. Microbiological documentation is rare, and empiric antibiotic regimens should cover the most commonly identified bacteria, i.e. streptococci Staphylococcus aureus. Other pathogens should be considered in case of immunosuppression or certain exposures. Necrotizing fasciitis (NF) is a severe but rare infection. Early surgical management in parallel with antibiotics is the cornerstone of treatment. Despite the high incidence of these infections, little progress has been made in their management and some areas of uncertainty exist, especially regarding the optimal duration of treatment, the prevention of recurrences and the use of polyclonal immunoglobulins for NF. This article reviews the main aspects of diagnosis and treatment of these infections.
皮肤感染是患者就诊的常见原因，但对医生来说，诊断可能具有挑战性。微生物学证据很少见，经验性抗生素治疗方案应覆盖最常见的病原体，即链球菌和金黄色葡萄球菌。在免疫抑制或某些暴露情况下，应考虑其他病原体。坏死性筋膜炎（NF）是一种严重但罕见的感染。早期手术治疗与抗生素治疗并行是治疗的基石。尽管这些感染发病率很高，但在其治疗方面进展甚微，仍存在一些不确定领域，特别是在最佳治疗持续时间、预防复发以及使用多克隆免疫球蛋白治疗NF方面。本文综述了这些感染的诊断和治疗的主要方面。
