Lee Bruce, Mroz Peter
Rochester General Hospital, Department of OBGYN, 1425 Portland Ave., Rochester, NY, 14621, United States of America.
Int J Surg Case Rep. 2022 Jul;96:107314. doi: 10.1016/j.ijscr.2022.107314. Epub 2022 Jun 14.
Necrotizing soft-tissue infections are life-threatening infections with significant morbidity and mortality.
A 36-year-old female gravida 1 para 1001 with a history of intravenous drug use and homelessness presented to the emergency department for a three-day history of labial pain, swelling, and fevers. A contrast tomography scan revealed necrotizing soft tissue infection of the mons and vulva with subcutaneous gas. Empiric broad-spectrum antibiotics were initiated. She underwent an emergent two-staged surgical debridement and delayed primary closure after 1-month in the hospital. She was discharged to complete a 9 to 12 month course of antibiotics. Multidisciplinary team was central to patient care.
Necrotizing soft tissue infections are a diverse group of infections affecting the subcutaneous tissue, muscle, and fascia. Actinomyces is a rare cause and require long-term antibiotics. Early recognition and emergent surgical debridement has been shown to reduce morbidity and mortality. A multidisciplinary approach is critical for proper wound care and healing, pain management, and long-term follow up.
Actinomyces-associated vulvar NSTIs are life-threatening infections requiring early surgical debridement, long-term antibiotics, and multidisciplinary approach.
坏死性软组织感染是具有显著发病率和死亡率的危及生命的感染。
一名36岁女性，孕1产1001，有静脉吸毒史且无家可归，因唇部疼痛、肿胀和发热3天就诊于急诊科。增强CT扫描显示会阴部和外阴坏死性软组织感染伴皮下气肿。开始使用经验性广谱抗生素治疗。她在住院1个月后接受了紧急两阶段手术清创，并延迟进行一期缝合。出院后完成9至12个月的抗生素疗程。多学科团队在患者护理中起着核心作用。
坏死性软组织感染是一组影响皮下组织、肌肉和筋膜的多种感染。放线菌是一种罕见病因，需要长期使用抗生素。早期识别和紧急手术清创已被证明可降低发病率和死亡率。多学科方法对于正确的伤口护理与愈合、疼痛管理及长期随访至关重要。
放线菌相关的外阴坏死性软组织感染是危及生命的感染，需要早期手术清创、长期使用抗生素及多学科方法。
