Diagnostic features of necrotizing fasciitis of the limb and literature review
Zhao Jian1, Sun Fatong1, Xing Baojie1, Wang Yong2, Lyu Lin1, Yu Xuechun1, Wang Haibin2, Jia Dailiang1,2
1College of Clinical Medicine, Jining Medical University, Jining 272013, China; 2Department of Emergency Surgery, Affiliated Hospital of Jining Medical University, Jining 272029, China
Abstract：ObjectiveTo investigate the clinical diagnostic features of necrotizing fasciitis of limbs. MethodsThe diagnosis and treatment of 2 cases of necrotizing fasciitis of limbs treated in the Department of Emergency Surgery of Affiliated Hospital of Jining Medical University on January 20, 2021， and March 27, 2021， were retrospectively analyzed, and related literatures were reviewed to summarize the symptomatic features, diagnostic methods, and treatment measures. ResultsOn arrival, patient 1 had hazy consciousness, swelling and pain in the right lower limb,chest, and abdominal wall, and subcutaneous undulation. During the operation, a significant amount of pus, necrotic subcutaneous tissue, and necrotic fascia were seen, displaying typical necrotizing fasciitis characteristics. The patient′s condition got better after fasciectomy debridement and wound negative pressure drainage, and awareness progressively cleared up. The right forearm and distal right upper arm were red, swollen, and painful when patient 2 was hospitalized. The results of the pathological examination were consistent with necrotizing fasciitis because they revealed fibroadipose tissue with acute and chronic inflammatory cell infiltration, abscess formation, inflammatory exudation, and necrosis. The infection was managed with numerous debridement procedures and negative pressure drainage. During surgery, it was noticed that both patients had necrotic subcutaneous tissue and fascia. The biological examination of the pathogen in 2 patients indicated that the pathogenic bacteria was group A beta-hemolytic streptococcus. ConclusionsThe initial signs of limb necrotizing fasciitis are uncommon. The biological analyses of infections and their clinical manifestations are crucial for diagnosis.
赵键 孙法同 邢宝杰 王勇 吕琳 于雪淳 王海滨 贾代良. 肢体坏死性筋膜炎的诊断学特征并文献复习[J]. 中华诊断学电子杂志, 2023, 11(2): 87-91.
Zhao Jian1, Sun Fatong, Xing Baojie, Wang Yong, Lyu Lin, Yu Xuechun, Wang Haibin, Jia Dailiang. Diagnostic features of necrotizing fasciitis of the limb and literature review. zhzdx, 2023, 11(2): 87-91.
