Infectious Diseases Center of Biomedical Research Excellence, Veterans Affairs Medical Center, 500 West Fort Street (Mail Stop 151), Boise, ID 83702, USA.
Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, Idaho State University, 1311 East Central Drive, Meridian, ID 83642, USA.
Infect Dis Clin North Am. 2021 Mar;35(1):135-155. doi: 10.1016/j.idc.2020.10.004. Epub 2020 Dec 7.
Necrotizing soft tissue infections occur after traumatic injuries, minor skin lesions, nonpenetrating injuries, natural childbirth, and in postsurgical and immunocompromised patients. Infections can be severe, rapidly progressive, and life threatening. Survivors often endure multiple surgeries and prolonged hospitalization and rehabilitation. Despite subtle nuances that may distinguish one entity from another, clinical approaches to diagnosis and treatment are highly similar. This review describes the clinical and laboratory features of necrotizing soft tissue infections and addresses recommended diagnostic and treatment modalities. It discusses the impact of delays in surgical debridement, antibiotic use, and resuscitation on mortality, and summarizes key pathogenic mechanisms.
坏死性软组织感染发生于创伤后、轻微皮肤损伤、非穿透性损伤、自然分娩以及术后和免疫功能低下的患者中。感染可能很严重，迅速进展，危及生命。幸存者常需接受多次手术和长时间住院及康复治疗。尽管可能存在细微差异，使一种疾病有别于另一种疾病，但在诊断和治疗方法上非常相似。本文综述了坏死性软组织感染的临床和实验室特征，并探讨了推荐的诊断和治疗方法。文中讨论了手术清创、抗生素使用和复苏延迟对死亡率的影响，并总结了关键的发病机制。
