Szilagyi Jacqueline, Kuester Victoria, Reznicek Julie
Department of Anesthesiology, Virginia Commonwealth University, Richmond, VA.
Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, VA.
J Pediatr Soc North Am. 2024 Feb 5;5(4):728. doi: 10.55275/JPOSNA-2023-728. eCollection 2023 Nov.
Necrotizing fasciitis (NF) is a rapidly progressing bacterial infection of the subcutaneous tissue that can be lifethreatening. Without prompt diagnosis and treatment, it can lead to septic shock, organ failure, and death. Due to the rarity of this disease in the pediatric population and the fact that initial symptoms are frequently nonspecific, NF in children is often misdiagnosed as cellulitis, which delays the correct treatment. Physicians must maintain a high index of suspicion and keep NF in mind because rapid surgical debridement is necessary to reduce morbidity and mortality. The purpose of this article is to better characterize what is currently known about NF within the pediatric population. In this article, the microbiology, pathophysiology, clinical manifestations, diagnosis, and treatment of pediatric NF are reviewed, and key differences between adult and pediatric NF are highlighted. •One must keep Necrotizing Fasciitis in mind when dealing with soft tissue infections.•A common symptom is a disproportionate level of pain for what can appear to be cellulitis.•Prompt treatment must include early, thorough, and frequently multiple debridements.•As a result of low incidences, collaborative multiple-center studies are needed to improve our level of understanding.
坏死性筋膜炎（NF）是一种皮下组织的快速进展性细菌感染，可危及生命。若不及时诊断和治疗，可导致感染性休克、器官衰竭和死亡。由于这种疾病在儿科人群中罕见，且初始症状往往不具特异性，儿童NF常被误诊为蜂窝织炎，从而延误正确治疗。医生必须保持高度的怀疑指数并牢记NF，因为快速手术清创对于降低发病率和死亡率至关重要。本文的目的是更好地描述目前已知的儿科人群中的NF情况。本文回顾了儿童NF的微生物学、病理生理学、临床表现、诊断和治疗，并强调了成人和儿童NF之间的关键差异。
•处理软组织感染时必须牢记坏死性筋膜炎。
•一个常见症状是对于看似蜂窝织炎的情况而言，疼痛程度不成比例。
•及时治疗必须包括早期、彻底且常常是多次的清创。
•由于发病率低，需要开展多中心合作研究以提高我们的认识水平。
