Uchikura Toshio, Mori Nobuaki, Kono Aki, Arino Hiroshi, Takahashi Takashi, Takeuchi Ichiro
Department of General Internal Medicine and Infectious Diseases, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
Department of Emergency Medicine, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
IDCases. 2020 Oct 21;22:e00980. doi: 10.1016/j.idcr.2020.e00980. eCollection 2020.
Group A (GAS) causes necrotizing soft tissue infections (NSTIs) necessitating exploration, surgical debridement, and possibly limb amputation.
A 45-year-old man presented with traumatic injury of the left carpal region, vomiting, and diarrhea. The swelling and pain in the left forearm worsened with sensorimotor deficits, and his skin color deteriorated. Emergent exploration was performed for limb preservation; GAS was detected in an exudate, and debridement was performed on postoperative day 2 for streptococcal toxic shock syndrome. He recovered uneventfully and was discharged; however, he returned after 2 months with GAS-induced STI at the same site and received antimicrobial treatment.
Exploration and subsequent debridement are crucial for effective treatment of NSTI.
A组链球菌（GAS）可引起坏死性软组织感染（NSTI），需要进行探查、手术清创，甚至可能需要截肢。
一名45岁男性因左手腕部外伤、呕吐和腹泻就诊。左前臂肿胀和疼痛加重，伴有感觉运动功能障碍，皮肤颜色变差。为保肢进行了急诊探查；在渗出物中检测到GAS，并在术后第2天对链球菌中毒性休克综合征进行了清创。他恢复顺利并出院；然而，2个月后他因同一部位的GAS引起的皮肤和软组织感染再次就诊并接受了抗菌治疗。
探查及随后的清创对于NSTI的有效治疗至关重要。
