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一名人类免疫缺陷病毒感染者发生福尼埃坏疽的病例。

A Case of Fournier's Gangrene in a Patient with Human Immunodeficiency Syndrome.

作者信息

Abdelmoneim Sahar S, McIntyre Mariah K, Lopez Milenis, Angly Sohair, Odalys Frontela

机构信息

General Internal Medicine, Larkin Community Hospital Palm Springs Campus, Hialeah, USA.

General Internal Medicine/Cardiovascular Medicine, Assiut University Hospitals, Asyut, EGY.

出版信息

Cureus. 2024 Dec 22;16(12):e76201. doi: 10.7759/cureus.76201. eCollection 2024 Dec.

Abstract

Fournier's gangrene (FG) is a type of necrotizing fasciitis affecting the abdomen or perineum. It is a polymicrobial infection that progresses to an obliterating endarteritis, causing thrombosis and subsequent tissue necrosis, allowing pathogenic invasion of interfacial planes.Patients with Fournier's gangrene typically have underlying systemic conditions that cause vascular insufficiencies or immunosuppression. This case describes a 55-year-old male patient with a medical history significant for HIV, obesity (BMI of 37), and smoking. The patient presented with generalized symptoms along with localized edema and erythema of the scrotum. Point-of-care ultrasound (POCUS) aided in evaluating the deeper structures for accurate diagnosis of Fournier's gangrene. Treatment followed current standards, including empiric antibiotics, analgesia, and surgical incision and drainage. The patient experienced an uncomplicated postoperative recovery despite his comorbidities due to prompt diagnosis and treatment.

摘要

福尼尔坏疽(FG)是一种累及腹部或会阴的坏死性筋膜炎。它是一种多微生物感染,会发展为闭塞性动脉内膜炎,导致血栓形成及随后的组织坏死,使病原菌侵入界面平面。福尼尔坏疽患者通常有导致血管功能不全或免疫抑制的潜在全身性疾病。本病例描述了一名55岁男性患者,有HIV病史、肥胖(体重指数为37)和吸烟史。患者出现全身症状,同时伴有阴囊局部水肿和红斑。床旁超声(POCUS)有助于评估更深层结构,以准确诊断福尼尔坏疽。治疗遵循现行标准,包括经验性抗生素治疗、镇痛以及手术切开引流。尽管该患者有多种合并症,但由于诊断和治疗及时,术后恢复顺利。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c93c/11750207/bb444f8124bd/cureus-0016-00000076201-i01.jpg

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