与链球菌中毒性休克综合征相关的A组链球菌坏死性感染
Necrotizing group A streptococcal infections associated with streptococcal toxic shock syndrome.
作者信息
Sellers B J, Woods M L, Morris S E, Saffle J R
机构信息
Department of Surgery, University of Utah School of Medicine, Salt Lake City 84132, USA.
出版信息
Am J Surg. 1996 Nov;172(5):523-7; discussion 527-8. doi: 10.1016/S0002-9610(96)00248-6.
BACKGROUND
Group A streptococci (GAS) cause a variety of life-threatening infectious complications, including necrotizing fasciitis (NF), purpura fulminans (PF), and streptococcal toxic shock syndrome (strepTSS), in which bacteremia is associated with shock and organ failure.
METHODS
We reviewed our experience in the management of patients with necrotizing GAS infections from 1991 to 1995.
RESULTS
Eight adult patients (6 NF, 2 PF) were identified. Patients presented with fever, leukocytosis, and severe pain, and rapidly developed shock and organ dysfunction. The diagnosis of strepTSS was confirmed in 6 cases. A total of 54 surgical procedures were required, including widespread debridements and amputations. Two patients died (25%).
CONCLUSIONS
Recognition of the need for aggressive diagnosis and surgical treatment of this most rapidly progressive surgical infection is necessary for successful management.
背景
A组链球菌（GAS）可引发多种危及生命的感染并发症，包括坏死性筋膜炎（NF）、暴发性紫癜（PF）和链球菌中毒性休克综合征（strepTSS），其中菌血症与休克及器官衰竭相关。
方法
我们回顾了1991年至1995年期间对坏死性GAS感染患者的治疗经验。
结果
共确定了8例成年患者（6例NF，2例PF）。患者表现为发热、白细胞增多和剧痛，并迅速发展为休克和器官功能障碍。6例确诊为strepTSS。总共需要进行54次外科手术，包括广泛的清创术和截肢术。2例患者死亡（25%）。
结论
认识到对这种进展最为迅速的外科感染进行积极诊断和手术治疗的必要性，对于成功治疗至关重要。
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