Critical Chest Wall Necrotizing Fasciitis Triggered by Herpes Zoster: A Case Report.

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Abdulrahman Manaa Alamri, Hajar Hassan Ali AlWadai, Nadia Ali Ismael Isaway
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引用次数: 0

Abstract

BACKGROUND Necrotizing fasciitis is an aggressive type of skin and soft tissue infection that results in necrosis of subcutaneous tissues, including muscle and fascia. Mixed bacteria, including gas-forming organisms, are usually identified. This report describes a 55-year-old male diabetic patient with herpes zoster involving the thoracic dermatomes complicated by skin infection, necrotizing fasciitis, chest wall abscess, and sepsis. CASE REPORT A 55-year-old man with diabetes mellitus presented with thoracic herpes zoster, initially treated with acyclovir and topical agents. He developed swelling, pain, and fever over the left chest, which was unresponsive to topical treatment. Investigations revealed elevated white blood cells and gas on chest X-ray. Computed tomography confirmed a 13×6×11-cm abscess with gas between the latissimus dorsi and serratus anterior muscles, suggesting necrosis. He received intravenous amoxicillin/clavulanic acid and metronidazole and underwent urgent surgical drainage, yielding 200 mL of pus. Cultures identified antibiotic-sensitive Staphylococcus aureus and Clostridium perfringens. Histopathology confirmed necrotizing tissue with acute bacterial inflammation. He was treated postoperatively with dressings and vacuum-assisted closure, followed by sutures, and was discharged in good condition after 16 days. CONCLUSIONS This case underscores the aggressive nature and potential complications of necrotizing soft tissue infections in patients with diabetes mellitus and herpes zoster. Prompt recognition, early intervention with appropriate antibiotics, and surgical drainage are crucial in managing such infections effectively. The successful use of vacuum-assisted closure therapy underscores its role in facilitating wound healing after debridement. Clinicians should maintain vigilance for necrotizing infections in similar high-risk patients to ensure early intervention and improve clinical outcomes.

带状疱疹引发的重症胸壁坏死性筋膜炎:病例报告。
背景坏死性筋膜炎是一种侵袭性皮肤和软组织感染,会导致包括肌肉和筋膜在内的皮下组织坏死。通常会发现混合细菌,包括产气菌。本报告描述了一名 55 岁男性糖尿病患者的带状疱疹累及胸部皮节,并发皮肤感染、坏死性筋膜炎、胸壁脓肿和败血症。病例报告 一位 55 岁的男性糖尿病患者出现胸部带状疱疹,最初使用阿昔洛韦和外用药物治疗。他的左胸部出现肿胀、疼痛和发热,局部治疗无效。检查发现白细胞升高,胸部 X 光片上有气体。计算机断层扫描证实,背阔肌和前锯肌之间有一个 13×6×11 厘米的脓肿,脓肿内有气体,表明脓肿已经坏死。他接受了阿莫西林/克拉维酸和甲硝唑静脉注射,并接受了紧急手术引流,引流出 200 毫升脓液。培养发现了对抗生素敏感的金黄色葡萄球菌和产气荚膜梭菌。组织病理学证实坏死组织伴有急性细菌性炎症。术后他接受了敷料和真空辅助闭合治疗,随后进行了缝合,16 天后康复出院。结论 本病例强调了糖尿病和带状疱疹患者坏死性软组织感染的侵袭性和潜在并发症。及时识别、早期使用适当的抗生素和手术引流是有效控制此类感染的关键。真空辅助闭合疗法的成功应用强调了其在清创后促进伤口愈合方面的作用。临床医生应对类似高危患者的坏死性感染保持警惕,以确保早期干预并改善临床效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American Journal of Case Reports
American Journal of Case Reports Medicine-Medicine (all)
CiteScore
1.80
自引率
0.00%
发文量
599
期刊介绍: American Journal of Case Reports is an international, peer-reviewed scientific journal that publishes single and series case reports in all medical fields. American Journal of Case Reports is issued on a continuous basis as a primary electronic journal. Print copies of a single article or a set of articles can be ordered on demand.
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