Necrotizing fasciitis secondary to Crohn's disease [Fulminante Fasciitis necroticans bei Morbus Crohn-assoziiertem Verlauf]

被引：0

作者：

Neuber M. ^{[1
,4
]}

Rieger H. ^{[2
]}

Brüwer M. ^{[1
]}

Poremba C. ^{[3
]}

Winde G. ^{[1
]}

机构：

[1] Klin. Poliklin. F. A., Westfälische Wilhelms-Univ., Münster

[2] Klin. F. Unfall- Hand- W., Clemenshospital GmbH, Westfälischen Wilhelms-Univ., Münster

[3] Gerhard-Domagk-Inst. F. Pathologie, Westfälische Wilhelms-Univ., Münster

[4] Klin. Poliklin. F. A., Westfälischen Wilhelms-Univ., 48129 Münster

来源：

Der Chirurg | 2000年 / 71卷 / 10期

关键词：

Crohn's disease; Group F streptococci; Inflammatory bowel disease; Necrotizing fasciitis;

D O I：

10.1007/s001040051215

中图分类号：

学科分类号：

摘要：

Necrotizing fasciitis is a life-threatening infection, commonly caused by group A streptococci, which has to be treated by surgical exploration and debridement during the first 24 h. Clinical clues are severe pain, in some cases followed by the appearance of bullous formations, and the detection of gas in the soft tissues by computed tomography or MRI. In addition to that, the infection is characterized by rapid inflammatory progression, producing a highly life-threatening situation. Diagnosis is finally based on surgical exploration obtaining specimens for culture and histopathologic examination. Debridement and exploration, in some cases amputation of the extremity, are indicated as soon as possible. Antibiotic therapy increases efficacy too, but there is no substitute for surgical treatment. Inflammatory bowel disease (Crohn's disease in this case) followed by necrotizing fasciitis is rarely mentioned in the literature. Therapeutic management in a situation of immunosuppression is discussed by illustration of an actual case.

引用

页码：1277 / 1280

页数：3

共 15 条

[1]

Bisno A.L., Stevens D.L., Streptococcal infections of skin and soft tissues, N Engl J Med, 334, (1996)

[2]

Brook I., Frazier E.H., Clinical and microbiological features of necrotizing fasciitis, J Clin Microbiol, 33, (1995)

[3]

Feingold D.S., Weinberg A.N., Group a streptococcal infections. An old adversary reemerging with new tricks ?, Arch Dermatol, 132, (1996)

[4]

Gilliland R., Whiteside M., Kirk S.J., Moorehead R.J., Necrotizing fasciitis: Two cases in a single family, Ulster Med J, 65, (1996)

[5]

Hackett S.P., Stevens D.L., Streptococcal toxic shock syndrome: Synthesis of tumor necrosis factor and interleukin-1 by monocytes stimulated with pyrogenic exotoxin a and streptolysin O, J Infect Dis, 165, (1992)

[6]

Hakett S.P., Stevens D.L., Superantigens associated with staphylococcal and streptococcal toxic shock syndrome are potent inducers of tumor necrosis factor-beta synthesis, J Infect Dis, 168, (1993)

[7]

Lille S.T., Sato T.T., Engrav L.H., Foy H., Jurkovich G.J., Necrotizing soft tissue infections: Obstacles in diagnosis, J Am Coll Surg, 182, (1996)

[8]

Meltzer D.L., Kabongo M., Necrotizing fasciitis: A diagnostic challenge, Am Fam Physician, 56, (1997)

[9]

Neurath M.F., Schurmann G., Zur Immunpathogenese der chronisch entzündlichen Darmerkrankungen, Chirurg, 71, (2000)

[10]

Schurmann G., Zelladhäsion -Molekulare Grundlagen und erste Aspekte für die Chirurgie, Chirurg, 68, (1997)

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