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皮肤与脓毒症:皮肤科对快速诊断的贡献。

Skin and sepsis: contribution of dermatology to a rapid diagnosis.

机构信息

Department of Dermatology, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo 46, 28007, Madrid, Spain.

Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain.

出版信息

Infection. 2021 Aug;49(4):617-629. doi: 10.1007/s15010-021-01608-7. Epub 2021 Apr 15.

Abstract

In patients who develop sepsis, whether due to primary, secondary or metastatic lesions, the skin is frequently affected. However, there are unresolved aspects regarding the general clinical manifestations in the skin or the prognosis and/or therapeutic implications. The main challenge in the approach to sepsis is its early diagnosis and management. In this review, we address the sepsis-skin relationship and the potential impact of early dermatological intervention on the septic patient through ten basic questions. We found little evidence of the participation of the dermatologist in sepsis alert programs. There are early skin changes that may alert clinicians on a possible sepsis, such as skin mottling or variations in acral skin temperature. In addition, the skin is an accessible and highly cost-effective tissue for etiological studies of some forms of sepsis (e.g., meningococcal purpura) and its involvement defines the prognosis of certain patients (e.g., infective endocarditis).

摘要

在发生败血症的患者中,无论是原发性、继发性还是转移性病变,皮肤通常都会受到影响。然而,皮肤的一般临床表现、预后和/或治疗意义仍存在一些未解决的问题。败血症处理的主要挑战是早期诊断和管理。在本次综述中,我们针对败血症与皮肤的关系,以及通过十个基本问题探讨早期皮肤科干预对败血症患者的潜在影响。我们发现皮肤科医生很少参与败血症警报方案。一些可能的败血症早期皮肤变化可能会提示临床医生,如皮肤斑驳或四肢皮肤温度变化。此外,皮肤是进行某些形式败血症(例如脑膜炎球菌性紫癜)病因研究以及评估某些患者预后(例如感染性心内膜炎)的一种可及且极具成本效益的组织。

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