Lally K P, Atkinson J B, Woolley M M, Mahour G H
Ann Surg. 1984 Jan;199(1):101-3. doi: 10.1097/00000658-198401000-00017.
We reviewed all cases of omphalitis seen at Childrens Hospital of Los Angeles from 1961 to 1981. One hundred and forty patients were seen and, of these, eight had necrotizing fasciitis. All patients with necrotizing fasciitis acquired omphalitis at home, making the incidence of necrotizing fasciitis over 10% in patients with community acquired omphalitis. Most of the infants appeared relatively well on admission with no fever but had a marked leukocytosis. The disease rapidly spread to involve most of the abdominal wall over a period of several hours to days. Seven of the eight patients died (87.5%). Five patients were operated upon but despite extensive resection of involved tissue, four died within 24 hours of surgery. A polymicrobial flora of both gram positive and gram negative bacteria was recovered in all patients cultured. The high incidence of necrotizing fasciitis following omphalitis in the newborn with its attendant morbidity and mortality mandates close observation of these infants with early surgical intervention if there is any question of the diagnosis.
我们回顾了1961年至1981年在洛杉矶儿童医院就诊的所有脐炎病例。共诊治了140例患者，其中8例患有坏死性筋膜炎。所有坏死性筋膜炎患者均在家中患上脐炎，社区获得性脐炎患者中坏死性筋膜炎的发病率超过10%。大多数婴儿入院时情况相对良好，无发热，但白细胞显著增多。疾病在数小时至数天内迅速蔓延至大部分腹壁。8例患者中有7例死亡（87.5%）。5例患者接受了手术，但尽管广泛切除了受累组织，4例在术后24小时内死亡。所有接受培养的患者均分离出革兰氏阳性菌和革兰氏阴性菌的混合菌群。新生儿脐炎后坏死性筋膜炎的高发病率及其伴随的发病率和死亡率要求对这些婴儿进行密切观察，如有任何诊断疑问应尽早进行手术干预。
