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轻微忽视性左手伤口后并发中毒性休克综合征和多器官功能衰竭的严重坏死性筋膜炎:病例报告及文献综述

Severe Necrotizing Fasciitis Following Minor Neglected Left-Hand Wound Complicated With Toxic Shock Syndrome and Multiorgan Failure: A Case Report and Literature Review.

作者信息

Hassanien Ahmad, Sewify Khaled, Alshaer Abdulaziz, Gomaa Wael, Shararibo Mohamed

机构信息

Critical Care, King Fahad Military Medical Complex, Dhahran, SAU.

出版信息

Cureus. 2025 Aug 19;17(8):e90537. doi: 10.7759/cureus.90537. eCollection 2025 Aug.

DOI:10.7759/cureus.90537
PMID:40988783
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12451225/
Abstract

Necrotizing fasciitis (NF) is a life-threatening soft tissue infection requiring urgent intervention. Despite advances in care, delays in diagnosis contribute to high morbidity and mortality. Here, we present a 17-year-old male patient previously healthy, who developed NF and toxic shock syndrome (TSS) following minor hand trauma. He developed multiorgan failure in the form of acute respiratory distress (ARDS), circulatory failure, high hepatic enzymes, and coagulopathy. The patient was managed successfully with early surgical debridement, antibiotics, immunoglobulins, and critical care support, including invasive mechanical ventilation and high-dose vasopressors and inotropic support. This case highlights NF's rapid progression in healthy individuals and the necessity of aggressive multidisciplinary management. Early recognition, prompt surgery, and tailored therapies remain critical. NF demands high clinical suspicion even in low-risk populations. Aggressive intervention and adherence to guidelines improve survival and functional outcomes.

摘要

坏死性筋膜炎(NF)是一种危及生命的软组织感染,需要紧急干预。尽管医疗有所进步,但诊断延迟导致高发病率和死亡率。在此,我们介绍一名17岁的既往健康男性患者,他在手部轻微创伤后发生了NF和中毒性休克综合征(TSS)。他出现了多器官功能衰竭,表现为急性呼吸窘迫(ARDS)、循环衰竭、高肝酶和凝血病。该患者通过早期手术清创、抗生素、免疫球蛋白和重症监护支持(包括有创机械通气以及高剂量血管加压药和正性肌力药支持)得到了成功治疗。本病例突出了NF在健康个体中的快速进展以及积极多学科管理的必要性。早期识别、及时手术和个性化治疗仍然至关重要。即使在低风险人群中,NF也需要高度的临床怀疑。积极干预和遵循指南可改善生存率和功能结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74e9/12451225/c0c125dd706c/cureus-0017-00000090537-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74e9/12451225/be521f775c5c/cureus-0017-00000090537-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74e9/12451225/5f863ed1bb06/cureus-0017-00000090537-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74e9/12451225/aaf46828d0ed/cureus-0017-00000090537-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74e9/12451225/c0c125dd706c/cureus-0017-00000090537-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74e9/12451225/be521f775c5c/cureus-0017-00000090537-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74e9/12451225/5f863ed1bb06/cureus-0017-00000090537-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74e9/12451225/aaf46828d0ed/cureus-0017-00000090537-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74e9/12451225/c0c125dd706c/cureus-0017-00000090537-i04.jpg

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