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低风险患者初次剖宫产术后发生的多微生物坏死性筋膜炎:一例病例报告及文献综述

Polymicrobial necrotizing fasciitis after a primary cesarean section in a low-risk patient: A case report and literature review.

作者信息

Chamseddine Nathalie, Aghar Hanan, Haidar Zeinab, Aoud Ghadir, Ibrahim Amir, Ghazeeri Ghina

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.

出版信息

Int J Surg Case Rep. 2024 Nov;124:110326. doi: 10.1016/j.ijscr.2024.110326. Epub 2024 Sep 21.

Abstract

INTRODUCTION AND IMPORTANCE

Necrotizing fasciitis (NF) is a rare life-threatening soft tissue infection, with only few obstetrical cases reported in the literature.

CASE PRESENTATION

We report a case of a previously healthy female who developed polymicrobial NF on day 4 post an uncomplicated primary cesarean delivery, who presented initially with fever, chills, and abdominal pain.

CLINICAL DISCUSSION

The patient underwent a life-saving debridement of surgical wound with subsequent positive wound culture with polymicrobial growth and pathology suggestive of necrotizing fasciitis. Patient recovered in the intensive care unit with smooth postoperative course.

CONCLUSION

Early diagnosis and presumed aggressive intervention with early surgical debridement and supportive therapy were key factors favoring the good prognosis seen in this patient.

摘要

引言与重要性

坏死性筋膜炎(NF)是一种罕见的危及生命的软组织感染,文献中仅报道了少数产科病例。

病例报告

我们报告一例既往健康的女性,在无并发症的初次剖宫产术后第4天发生了多微生物性NF,最初表现为发热、寒战和腹痛。

临床讨论

患者接受了挽救生命的手术伤口清创术,随后伤口培养呈阳性,有多种微生物生长,病理提示坏死性筋膜炎。患者在重症监护病房康复,术后过程顺利。

结论

早期诊断以及早期手术清创和支持治疗等积极干预措施是该患者预后良好的关键因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5ef/11562401/02ca77f515ec/gr1.jpg

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