Kanoh T
Department of Internal Medicine, Faculty of Medicine, Kyoto University.
Rinsho Ketsueki. 1996 Nov;37(11):1309-13.
Necrotizing fasciitis is a rare but often fatal soft-tissue infection primarily involving the superficial fascia and fat tissue resulting in extensive undermining of surrounding tissues. Skin is initially spared, but as necrotizing fasciitis spreads, all the soft-tissue components, including the skin, become involved. The progression of necrotizing fasciitis is often fulminant, and the prognosis depends to a large extent on the rapidity of correct diagnosis and surgical treatment (debridement). Most of the patients affected with necrotizing fasciitis have some risk factors: chronic general or local diseases, leukopenia, immunodeficiency diseases, malignancies, and an age of 50 years or more. The author reported the occurrence of necrotizing fasciitis in a 69-year-old man with multiple myeloma during the granulocytopenic phase after chemotherapy. The successful treatment of necrotizing fasciitis in the present case relied not only on surgical debridement, but also on G-CSF administration.
坏死性筋膜炎是一种罕见但往往致命的软组织感染，主要累及浅筋膜和脂肪组织，导致周围组织广泛破坏。起初皮肤未受影响，但随着坏死性筋膜炎的扩散，包括皮肤在内的所有软组织成分都会被累及。坏死性筋膜炎的进展通常很迅猛，其预后在很大程度上取决于正确诊断和手术治疗（清创）的速度。大多数坏死性筋膜炎患者都有一些危险因素：慢性全身性或局部疾病、白细胞减少、免疫缺陷疾病、恶性肿瘤以及年龄在50岁及以上。作者报告了一名69岁患有多发性骨髓瘤的男性在化疗后的粒细胞缺乏期发生坏死性筋膜炎的病例。本病例中坏死性筋膜炎的成功治疗不仅依赖于手术清创，还依赖于粒细胞集落刺激因子的使用。
