坏死性筋膜炎1例报告

坏死性筋膜炎１例报告王克威（沪州医学院附属医院皮肤科，６４６０００）朱某某，女，６３岁，因左下肢突然出现大片水肿性红斑、水疱、血疱伴剧烈疼痛于１９９４年８月１５日入院。８月１３日病人感畏寒不适，服感冒冲剂后好转。次日左大腿内侧突然出现大片边界清楚的水...     

坏死性筋膜炎1例

报告1例坏死性筋膜炎。患者女,57岁。右手背及上肢红肿热痛伴溢脓4d。切开引流见皮下组织及筋膜广泛坏死、液化。皮损组织病理检查示,纤维蛋白样坏死及大量中性粒细胞浸润,脓肿形成。患者乙肝病史多年,住院期间出现大量腹水。经抗生素治疗、局部清创、反复输新鲜血浆和白蛋白,病情稳定,后经植皮痊愈。     

坏死性筋膜炎1例

报告1例具有典型症状的坏死性筋膜炎,患者女,70岁,皮损位于左臀部和左大腿,为显著性红斑,硬结、片状坏死,皮损有恶臭,组织中有产气现象,自觉疼痛剧烈,经组织病理检查确诊为坏死性筋膜炎,对患者施行清创术和对症支持治疗,包括消炎,镇痛和补液,获得令人满意的疗效。     

儿童坏死性筋膜炎1例

临床资料患儿,男,6岁。主因右股前内侧皮肤肿胀变黑伴发热11天,于2008年12月26日收住我院。患儿11天前右股前内侧出现直径2mm的白色水疱,     

绿脓杆菌所致坏死性筋膜炎1例

患者女性,25岁,1个月前两小腿及足背出现瘙痒性丘疹。剧烈搔抓后两足背出现深在潜行性溃疡,有较多分泌物及腥臭味。分泌物连续3次培养均为铜绿假单胞菌。经长程敏感抗生素全身应用、支持疗法及局部治疗,40天后溃疡愈合。     

坏死性筋膜炎

坏死性筋膜炎姚健，何启红综述（四川泸州市人民医院，６４６０００）马华锋审校（沪州医学院附属医院皮肤科）坏死性筋膜炎（ＮｅｃｒｏｔｉｚｉｎｇＦａｓｃｉｉｔｉｓ，ＮＦ）是一种少见的以侵犯筋膜为主并可累及皮肤、皮下组织为特征的急性坏死性软组织感染。如诊治不...     

水痘并发坏死性筋膜炎1例

1 病历摘要 患者男.19岁.因发热、全身出现丘疹和水疱3 d,于2008年3月10日就诊于我科.患者一般情况良好,体温37.8℃,周身散在水疱、丘疹,口腔黏膜见粟粒大糜烂.患者有水痘患者接触史,诊断为水痘,给予相应处理.3月14日患者复诊时发现躯干水疱干涸、结痂,部分水疱周围有红晕,背部皮肤局部红肿,有压痛.     

坏死性筋膜炎及其诊疗对策

坏死性筋膜炎是一种进展很快的皮肤病,表现为沿深、浅筋膜播散的感染,可累及血管形成血栓,引起相应皮肤、皮下组织及筋膜的坏死.该病分为两型,Ⅰ型为昆合细菌感染;Ⅱ型多由A组-β溶血性链球菌所致,常伴有休克及多器官衰竭,死亡率高,又被称为"嗜肉细菌感染".该病早期诊断十分困难,主要依靠临床表现.治疗主要是纠正休克及多器官损伤,应用敏感抗生素及彻底引流清创等.     

外用糖皮质激素致坏死性筋膜炎1例

患者男,30岁.近2年来因包皮及龟头反复出现红斑,自行长期外用复方康纳乐霜、复方曲安奈德霜(派瑞松)、皮炎平等多种复方糖皮质激素制剂治疗,病情时好时坏.半年前局部皮肤、黏膜损害进一步加重,面积不断扩大,延及会阴、腹股沟、大腿内侧及下腹部,并出现大面积皮肤坏死,大量脓液渗出.     

切痂植皮治愈婴儿坏死性筋膜炎1例

患儿男,11个月。发热11天、右臀部出现红肿9天。皮损渐扩大加重,出现腰背、臀部、右大腿皮肤片状坏死,质硬呈黑色。皮损组织病理符合坏死性筋膜炎。全麻下行坏死创面清除并予植皮,20天后治愈出院。     

Necrotizing fasciitis: report of 39 pediatric cases

BACKGROUND: Necrotizing fasciitis (NF) is a severe, life-threatening soft tissue infection. General features and risk factors for fatal outcome in children are not well known. OBJECTIVE: To characterize the features of NF in children and the risk factors for fatal outcome. DESIGN: Retrospective, comparative, observational, and longitudinal trial. SETTING: Dermatology department of a tertiary care pediatric hospital. PATIENTS: All patients with clinical and/or histopathological diagnosis of NF seen from January 1, 1971, through December 31, 2000. MAIN OUTCOME VARIABLES: Incidence, age, sex, number and location of lesions, preexisting conditions, initiating factors, clinical and laboratory features, diagnosis at admission, treatment, evolution, sequelae, and risk factors for fatal outcome. RESULTS: We examined 39 patients with NF (0.018% of all hospitalized patients). Twenty-one patients (54%) were boys. Mean age was 4.4 years. Single lesions were seen in 30 (77%) of patients, with 21(54%) in extremities. The most frequent preexisting condition was malnutrition in 14 patients (36%). The most frequent initiating factor was varicella in 13 patients (33%). Diagnosis of NF at admission was made in 11 patients (28%). Bacterial isolations in 24 patients (62%) were polymicrobial in 17 (71%). Pseudomonas aeruginosa was the most frequently isolated bacteria; gram-negative isolates, the most frequently associated bacteria. Complications were present in 33 patients (85%), mortality in 7 (18%), and sequelae in 29 (91%) of 32 surviving patients. The significant risk factor related to a fatal outcome was immunosuppression. CONCLUSIONS: Necrotizing fasciitis in children is frequently misdiagnosed, and several features differ from those of NF in adults. Immunosuppression was the main factor related to death. Early surgical debridement and antibiotics were the most important therapeutic measures.     

Necrotizing fasciitis

Necrotizing fasciitis is an uncommon, rapidly spreading infection, affecting primarily the deep fascia, which may result in secondary necrosis of the subcutaneous tissue, fascia and muscle. We report a patient that had the cardinal features; namely, excruciatingly painful lesions, demonstration of gas in the tissue and an obnoxious foul odor, prominent erythema, induration, patchy necrosis, and loss of sensation in the left buttock and thigh. Its onset probably followed inadvertent trauma/injury of the left buttock. Corroborative microscopic pathology confirmed the diagnosis. Debridement and intensive supportive therapy comprising antibiotics, analgesics and fluids were given. The outcome of the therapy was gratifying.     

Necrotizing fasciitis: pathophysiology and treatment

Necrotizing fasciitis (NF) is a life-threatening bacterial infection causing necrosis of the fascia, underlying skin, and vasculature. NF spreads rapidly, making immediate diagnosis important for survival. Treatment may involve the administration of several broad-spectrum antibiotics, surgical debridement, and skin grafting. In the following two articles, the pathophysiology, medical management, and nursing care of patients are discussed. An in-depth model care plan illustrates the complexity of the disease and its treatment.     

Necrotizing fasciitis: a deadly infection

Necrotizing fasciitis (NF) is a life-threatening condition, consisting of a soft-tissue infection with rapidly progressive, widespread fascial necrosis. NF may be caused by a wide variety of microbes. Indeed, NF may be an infection of one species of bacteria or may be polymicrobial. Prompt diagnosis and treatment are essential. Surgical debridement and antibiotic therapy are the primary treatment options.     

血管内筋膜炎2例

报告2例发生在掌跖部位的血管内筋膜炎.例1.女,65岁.右跖皮下结节1个月.例2.男,76岁.右掌蓝色皮下结节5年.2例患者皮损组织病理检查均显示扩张的血管内大量梭形细胞增生:免疫组化染色结果示增生的梭形细胞波形蛋白、平滑肌肌动蛋白阳性,CD31和CD34阴性.结合临床及组织病理特点诊断为血管内筋膜炎.     

结节性筋膜炎2例

报告2例结节性筋膜炎.患者均为年轻男性,表现为四肢突然出现的单发皮下结节,组织病理和免疫组化检查结果符合结节性筋膜炎改变.该病较少见,临床表现无明显特征,组织病理形态较复杂,误诊率高,该文结合文献复习了结节性筋膜炎的临床、组织病理学和免疫表型改变,总结了鉴别诊断的要点.