Gilardi Roberta, Parisi Paola, Galassi Luca, Firmani Guido, Bene Massimo Del
Division of Plastic & Reconstructive Surgery, San Gerardo Hospital of Monza, Italy.
Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute IRCCS Rome, Italy.
JPRAS Open. 2023 Oct 5;38:129-133. doi: 10.1016/j.jpra.2023.10.004. eCollection 2023 Dec.
Necrotizing fasciitis is a rare and potentially life-threatening soft tissue infection, even more so when associated with fungal causative agents. Onset has been identified in nosocomial settings following elective surgery, but not in esthetic surgery.
We here present a case of necrotizing fasciitis related to infection which occurred in an immunocompetent patient who received a cosmetic breast augmentation mastopexy combined with a Brazilian Butt Lift using autologous fat grafting. The case was managed with aggressive wound exploration and debridement. Treatment was delayed by the diagnostic challenge and the difficulty in identifying the causative agent, but the patient fully healed and recovered once the was isolated in culture tests and appropriate antimycotic treatment was implemented.
Considerations should be made regarding the possibility of implementing an antimycotic option for first-line empirical treatment despite the rarity of fungal etiology because of the threat of diagnostic delay and worse outcome.
坏死性筋膜炎是一种罕见且可能危及生命的软组织感染,当与真菌病原体相关时更是如此。已发现在择期手术后的医院环境中发病,但在美容手术中未发现。
我们在此报告一例与感染相关的坏死性筋膜炎病例,该病例发生在一名免疫功能正常的患者身上,该患者接受了隆胸乳房固定术联合自体脂肪移植的巴西臀部提升术。该病例通过积极的伤口探查和清创进行处理。诊断挑战和确定病原体的困难导致治疗延迟,但一旦在培养试验中分离出病原体并实施适当的抗真菌治疗,患者完全愈合并康复。
尽管真菌病因罕见,但考虑到诊断延迟和更差结果的威胁,应考虑在一线经验性治疗中实施抗真菌方案的可能性。