Necrotizing fasciitis secondary to lake water inoculation with Aeromonas sobria: A case report.
Necrotizing fasciitis secondary to lake water inoculation with Aeromonas sobria: A case report.
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DOI：
10.1097/md.0000000000024981
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发表时间：
2021-03-12
期刊：
影响因子：
1.6
通讯作者：
Mailey BA
中科院分区：
文献类型：
--
作者：
Hutchinson LE;Franke JD;Mailey BA
坏死性筋膜炎（NF）是一种进展迅速、死亡率高的细菌性软组织感染。它的特点是明显的软组织破坏和相关的败血症。治疗的主要内容是适当的广谱抗生素治疗和紧急手术清创。既往健康的66岁女性右侧小腿后部出现深度撕裂伤，随后被湖水污染。冲洗缝合创面后，患者出现NF。右下肢撕裂伤并发继发于温和气单胞菌的NF。患者接受紧急手术清创，静脉注射广谱抗生素和负压伤口治疗。采用裂厚皮片重建下肢。患者最初的穿透性创伤在急诊室被关闭，患者出院时使用抗生素。她第二天回来时生命体征不稳定，被送进了重症监护病房。她的病情继续恶化，她接受了一系列手术清创。患者病情好转，住院13天后出院。密切监测NF对水生环境中持续的组织感染很重要。及时发现和手术治疗NF可提高总生存率。
Necrotizing fasciitis (NF) is a rapidly progressing bacterial soft tissue infection with a high mortality rate. It is characterized by significant soft tissue destruction with associated sepsis. The mainstay of treatment is coverage with appropriate broad-spectrum antibiotic therapy and emergent surgical debridement. A previously healthy 66-year-old female presented with a deep laceration to her right, posterior calf with subsequent contamination with lake water. After the wound was irrigated and closed, the patient developed NF. Laceration of the right lower extremity complicated by NF secondary to Aeromonas sobria. The patient underwent emergent surgical debridements with intravenous broad-spectrum antibiotics and negative pressure wound therapy. The lower extremity was reconstructed with split-thickness skin grafts. The patient's initial penetrating trauma was closed in the emergency room, and the patient was discharged home with antibiotics. She returned the next day with unstable vitals and was admitted to the intensive care unit. Her condition continued to deteriorate, and she underwent serial surgical debridements. Her condition improved and was discharged home after 13 days in the hospital. Close monitoring for NF is important for tissue infections sustained in aquatic environments. Timely identification and surgical management of NF increases overall survival.