Edwards J D, Schofield P M
Br Med J (Clin Res Ed). 1984 Mar 17;288(6420):816-7. doi: 10.1136/bmj.288.6420.816.
A previously healthy woman developed streptococcal cellulitis of the leg after falling and lacerating her knee. On admission her blood pressure was unrecordable and her respiratory rate greater than 60 beats/minute. Mechanical ventilation was necessary, and plasma volume expansion was started, with little effect. Infusion of dopamine restored the blood pressure to 150/90 mm Hg, but interrupting the infusion for as little as 30 seconds resulted in profound hypotension. Insertion of a second central venous catheter allowed the dopamine to be given continuously, and the infusion was stopped successfully four days after her admission. She eventually made a complete recovery. This case highlights the need for intensive supportive treatment in many streptococcal infections and, in particular, the need for inotropic support.
一名既往健康的女性在摔倒并膝部撕裂后发生了腿部链球菌性蜂窝织炎。入院时她的血压无法测得，呼吸频率超过60次/分钟。需要进行机械通气，并开始进行血浆容量扩充，但效果甚微。输注多巴胺使血压恢复到150/90 mmHg，但多巴胺输注中断短短30秒就会导致严重低血压。插入第二根中心静脉导管后得以持续输注多巴胺，入院四天后成功停止输注。她最终完全康复。该病例凸显了许多链球菌感染需要强化支持治疗，尤其是需要进行强心支持治疗。
