Johnson Miguel, Berner Juan, Christopoulos George, Hamilton Preci, Pearl Robert
Department of Plastic Reconstructive & Aesthetic Surgery, Queen Victoria Hospital NHS Trust, East Grinstead, UK.
Division of Neurosurgery, Department of Surgery, Cornwall Regional Hospital, Montego Bay, Jamaica.
J Surg Case Rep. 2020 Sep 23;2020(9):rjaa372. doi: 10.1093/jscr/rjaa372. eCollection 2020 Sep.
Glucocorticoids are commonly used in the management of patients with brain Tumour for reducing peritumoral and vasogenic edema. However, they may lead to development of limb and life-threatening conditions such as necrotizing fasciitis (NF). NF is a rare but potentially lethal condition. Early detection and aggressive treatment may lead to decreased mortality and limb salvage. The diagnosis is predominately clinical but may be supported by laboratory and radiological investigations. Chronic steroid use not only predisposes to the development of NF but also may mask early features delaying presentation and diagnosis. Clinicians should have a high index of suspicion especially in patients on chronic steroid therapy as this may aid in early detection and treatment. We present a case report of a successful limb salvage that exemplifies these points.
糖皮质激素常用于脑肿瘤患者的治疗，以减轻瘤周和血管源性水肿。然而，它们可能导致肢体病变和危及生命的疾病，如坏死性筋膜炎（NF）。NF是一种罕见但可能致命的疾病。早期发现和积极治疗可能会降低死亡率并挽救肢体。诊断主要基于临床，但实验室和影像学检查也可提供支持。长期使用类固醇不仅易引发NF，还可能掩盖早期症状，延迟就诊和诊断。临床医生应保持高度警惕，尤其是对于长期接受类固醇治疗的患者，这有助于早期发现和治疗。我们报告一例成功挽救肢体的病例，以说明这些要点。
