McHenry C R, Azar T, Ramahi A J, Collins P L
Department of Surgery, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, Ohio, USA.
Obstet Gynecol. 1996 May;87(5 Pt 2):823-6.
Necrotizing fasciitis is an uncommon, rapidly progressive, life-threatening infection involving the subcutaneous tissue and fascia. Usually, it is a synergistic polymicrobic infection that occurs in patients with coexisting factors predisposing them to bacterial inoculation and the spread of infection.
We report a monomicrobial variant of necrotizing fasciitis affecting three otherwise healthy pregnant or postpartum women. The necrotizing fasciitis involved either the lower extremity or the abdominal wall. The causative bacteria were Streptococcus pyogenes (two cases) and Staphylococcus aureus (one). All patients presented with an acute fulminant infection, including one woman who died from overwhelming sepsis.
These cases raise a question about the possible role of increased bacterial virulence and the immunologic changes of pregnancy as potential predisposing factors in the development of necrotizing fasciitis.
坏死性筋膜炎是一种罕见的、进展迅速、危及生命的感染，累及皮下组织和筋膜。通常，它是一种协同性多微生物感染，发生于有易导致细菌接种和感染扩散的并存因素的患者。
我们报告了坏死性筋膜炎的一种单微生物变种，影响了三名其他方面健康的孕妇或产后妇女。坏死性筋膜炎累及下肢或腹壁。致病细菌为化脓性链球菌（两例）和金黄色葡萄球菌（一例）。所有患者均表现为急性暴发性感染，其中一名女性死于严重脓毒症。
这些病例引发了一个问题，即细菌毒力增加和妊娠免疫变化作为坏死性筋膜炎发生发展的潜在易感因素可能发挥的作用。
