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[右侧全胸暴发性气性坏疽的致命病程]

[Fatal course of a fulminant gas gangrene of the right hemithorax].

作者信息

Neumann Christoph J, Unterberg Matthias, Mesbah Daniel, Sandfort Mark, Smektala Rüdiger

机构信息

Klinik für Unfallchirurgie und Orthopädie, Universitätsklinikum Knappschaftskrankenhaus Bochum, In der Schornau 23-25, 44892, Bochum, Deutschland.

Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Knappschaftskrankenhaus Bochum, Bochum, Deutschland.

出版信息

Unfallchirurgie (Heidelb). 2025 Jan;128(1):59-63. doi: 10.1007/s00113-024-01490-6. Epub 2024 Oct 10.

Abstract

The full clinical picture of a gas gangrene infection is an absolute rarity. The mechanism of development can be either traumatic or spontaneous (e.g., hematogenous seeding in occult colon carcinoma). In particular, the rare pathogen Clostridium septicum appears to be associated with spontaneously occurring gas gangrene. Diabetes mellitus is a significant risk factor. The mortality rate of the disease is around 50%, even with maximum therapeutic efforts, and the course of the disease is fulminant in the majority of cases. Initial symptoms are unspecific and make early diagnosis difficult. Treatment consists of high-dose antibiotics in combination with radical surgical debridement and, if necessary, supplementary hyperbaric oxygen therapy.

摘要

气性坏疽感染的完整临床表现极为罕见。其发病机制可以是创伤性的,也可以是自发性的(例如,隐匿性结肠癌的血行播散)。特别是,罕见病原体败血梭菌似乎与自发性气性坏疽有关。糖尿病是一个重要的危险因素。即使进行最大程度的治疗,该病的死亡率仍约为50%,且在大多数情况下病情发展迅猛。初始症状不具特异性,难以早期诊断。治疗包括大剂量抗生素联合根治性手术清创,必要时辅以高压氧治疗。

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