ABSTRACT
Las grandes pérdidas de la cobertura cutánea y los fenómenos toxo-inflamatorios que se asocian, ya se trate de quemaduras, necrolisis tóxica epidérmica o porcesos bacterianos productores de toxinas con gran destrucción tisular, configuran una situación clínica crítica con alto riesgo de vida. Con los principios de tratamiento de grandes quemados, el control de la infección local y sistémica, el sostén clínico intensivo en una unidd de máxima complejidad y la adecuada asistencia nutricional y respiratoria se pudo tratar satisfactoriamente una fascitis necrotizante con pérdida de la cobertura cutánea en aproximadamente un 30 por ciento de la SCT causada por una infección de Estreptococo beta hemolítico grupo A en un recién nacido pretérmino (RNPT) de 1287g al nacer.(AU)
Subject(s)
Male , Humans , Infant, Newborn , Fasciitis, Necrotizing/physiopathology , Fasciitis, Necrotizing/therapy , Hyaline Membrane Disease , Shock, SepticSubject(s)
Acute Kidney Injury/microbiology , Sepsis/complications , Acute Kidney Injury/physiopathology , Acute Kidney Injury/therapy , Fasciitis, Necrotizing/complications , Fasciitis, Necrotizing/physiopathology , Humans , Lipopolysaccharides , Male , Middle Aged , Parenteral Nutrition , Prognosis , Renal Dialysis , Sepsis/physiopathologyABSTRACT
Necrotizing fasciitis is a rare soft tissue infection and a life-threatening emergency, often fatal. Its incidence and management are described plentifully in the medical literature regarding the most common anatomical sites involved like the abdomen, lower and upper limbs, and perineum. However, available data and case reports of chest wall necrotizing fasciitis after thoracic procedures are scarce, mainly after major cardiac operations. We report and discuss a case of necrotizing fasciitis of the chest wall occurring in the immediate postoperative period of a cardiac procedure, and include a brief review of the concepts, pathophysiology, and treatment reported in the medical literature. We emphasize the need for early diagnosis and urgent and effective surgical debridement. Of importance is the fact that we have not found any references in the literature to cases similar or equal to the one we describe here, which occurred in the postoperative period of a cardiac procedure.
Subject(s)
Fasciitis, Necrotizing/surgery , Postoperative Complications/surgery , Soft Tissue Infections/surgery , Adult , Aortic Aneurysm, Thoracic/surgery , Aortic Valve Insufficiency/surgery , Debridement/methods , Drainage/methods , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/physiopathology , Humans , Male , Marfan Syndrome/complications , Postoperative Complications/diagnosis , Postoperative Complications/physiopathology , Soft Tissue Infections/diagnosis , Soft Tissue Infections/physiopathologyABSTRACT
Necrotizing fasciitis is a rare soft tissue infection and a life-threatening emergency, often fatal. Its incidence and management are described plentifully in the medical literature regarding the most common anatomical sites involved like the abdomen, lower and upper limbs, and perineum. However, available data and case reports of chest wall necrotizing fasciitis after thoracic procedures are scarce, mainly after major cardiac operations. We report and discuss a case of necrotizing fasciitis of the chest wall occurring in the immediate postoperative period of a cardiac procedure, and include a brief review of the concepts, pathophysiology, and treatment reported in the medical literature. We emphasize the need for early diagnosis and urgent and effective surgical debridement. Of importance is the fact that we have not found any references in the literature to cases similar or equal to the one we describe here, which occurred in the postoperative period of a cardiac procedure
Subject(s)
Humans , Male , Adult , Cardiac Surgical Procedures/adverse effects , Fasciitis, Necrotizing/surgery , Postoperative Complications/surgery , Soft Tissue Infections/surgery , Thorax/microbiology , Debridement/methods , Drainage/methods , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/physiopathology , Postoperative Complications/diagnosis , Postoperative Complications/physiopathology , Soft Tissue Infections/diagnosis , Soft Tissue Infections/physiopathologyABSTRACT
Dentro de las infecciones necrotizantes de tejidos blandos, la fascitis necrotizante sigue siendo un desafío para los cirujanos por lo cual se realizó la siguiente revisión bibliográfica en la que se detalla la etiología, fisiopatología, histopatología, cuadro clínico, exámenes de laboratorio, diagnóstico diferencial y tratamiento temprano, que permitirán diagnosticar oportunamente y manejar de mejor manera ésta patología.
Subject(s)
Humans , Fasciitis, Necrotizing/etiology , Fasciitis, Necrotizing/physiopathology , Fasciitis, Necrotizing/therapyABSTRACT
A fasciíte necrotizante é uma infecçäo dos tecidos moles, causada geralmente por bactérias virulentas produtoras de toxinas. Caracteriza-se por necrose ampla do tecido celular subcutâneo e fáscias, com relativa preservaçäo da pele e músculos adjacentes. Está freqüentemente associada com toxemia sistêmica grave, sendo geralmente fatal se näo reconhecida prontamente e tratada de modo agressivo. As medidas terapêuticas específicas incluem o desbridamento cirúrgico, antibioticoterapia e medidas de suporte, como administraçäo de líquidos intravenosos e monitorizaçäo hemodinâmica.
Subject(s)
Humans , Fasciitis, Necrotizing/therapy , Gangrene , Hyperbaric Oxygenation , Debridement , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/epidemiology , Fasciitis, Necrotizing/physiopathology , Gangrene/diagnosis , Gangrene/mortality , Gangrene/physiopathology , PrognosisABSTRACT
Necrotizing fasciits (NF) is a rapidly progressive disease characterized by extensive necrosis of the fascia, skin, and subcutaneous tissue, with characteristical sparing of the underlying muscle. It is considered to be a rare entity and is associated with a high mortality rate since early recognition and treatment are not provided. Extensive surgical debridement of all necrotic tissues and appropriate antimicrobial treatment are the cornerstones for a successful treatment. We present a case of NF in a 36-year-old man and discuss it's pathophysiology, clinical manifestations and the best therapeutic choice for this potential life threatening disease.
Subject(s)
Fasciitis, Necrotizing , Adult , Debridement , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/drug therapy , Fasciitis, Necrotizing/physiopathology , Humans , MaleABSTRACT
Os autores apresentam estudo retrospectivo de 12 pacientes com fasciite necrosante da genitália masculina (Síndrome de Fournier), tratados no período de outubro de 1982 a maio de 1997. A idade variou de quatro a 72 anos, com média de 48,8 anos. O tratamento consistiu em cistostomia em cinco casos, antibioticoterapia sistêmica de largo espectro, desbridamentos agressivos e técnicas de reconstruçäo por cirurgia plástica (retalhos e enxertos cutâneos). Näo houve óbitos na série estudada e näo foram observadas seqüelas relevantes. Os autores concluem que o tratamento utilizado foi eficaz na abordagem da doença