术后脓胸合并下行性坏死性筋膜炎：一例报告

Postoperative empyema complicated with descending necrotizing fasciitis: a case report.

作者信息

Kadomatsu Yuka, Ueno Harushi, Goto Masaki, Ozeki Naoki, Nakamura Shota, Chen-Yoshikawa Toyofumi Fengshi

机构信息

Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.

出版信息

Surg Case Rep. 2022 Jul 15;8(1):133. doi: 10.1186/s40792-022-01492-9.

DOI:10.1186/s40792-022-01492-9

PMID:35836035

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9283599/

Abstract

BACKGROUND

Empyema is a serious complication of lung surgery.

CASE PRESENTATION

We report a case of Streptococcus anginosus empyema complicated by descending necrotizing fasciitis after surgery. Ten days after the initial surgery, the patient presented with arrhythmia and hypotension with septic shock. Pleural fluid analysis led to the diagnosis of empyema, and surgical debridement (second surgery) was performed. One week after the emergency surgery, a palpable pink erythematous skin change was observed on the ipsilateral iliac crest. Hence, the second emergency surgery (third surgery) was performed to debride the subcutaneous and intramuscular abscesses.

CONCLUSIONS

The possibility of descending abscess and necrotizing fasciitis should be considered when Streptococcus anginosus is detected.

摘要

背景

脓胸是肺手术的严重并发症。

病例报告

我们报告一例手术后由咽峡炎链球菌引起的脓胸并发下行性坏死性筋膜炎的病例。初次手术后10天，患者出现心律失常和低血压并伴有感染性休克。胸腔积液分析确诊为脓胸，并进行了手术清创（第二次手术）。急诊手术后一周，在同侧髂嵴处观察到可触及的粉红色皮肤红斑变化。因此，进行了第二次急诊手术（第三次手术）以清除皮下和肌肉内脓肿。