一位49歲女性以反覆性右膝紅腫痛表現

臨床上，右膝紅腫痛，常先入為主被認為是關節炎、痛風或是蜂窩性組織炎。本案例是一位49歲女性患者，反覆性右膝紅腫痛被診斷為蜂窩性組織炎，因右膝疼痛與局部皮膚損傷程度不一致，經電腦斷層和組織切片確診為壞死性筋膜炎，於施行筋膜切開術、反覆性清創及膝上截肢手術後，感染方獲得控制、順利地出院。針對此類以反覆性右膝紅腫痛表現的患者，當抗生素治療效果不彰、臨床表現與疼痛程度不成比例時，必須將壞死性筋膜炎列為鑑別診斷，以免錯失治療先機。

關鍵字

蜂窩性組織炎；壞死性筋膜炎；清創；截肢

並列摘要

In clinical practice, right knee inflammation and pain is frequently considered to be caused by arthritis, gout, or cellulitis. In this case, a 49-year-old female patient who experienced recurrent right knee inflammation and pain was initially diagnosed with cellulitis. However, her right knee refractory pain and local skin damage showed conflicting results. A computed tomography scan and biopsy were performed and necrotizing fasciitis was revealed. Fasciotomy, repeated debridement and subsequent above-knee amputation were perfoemed. The infection was eventually controlled and she was then discharged. For patients with recurrent right knee inflammation and refractory pain, when the antibiotic treatment is not effective and the clinical manifestation mismatches with pain score, necrotizing fasciitis must be considered as a possible differential diagnosis for punctual treatment.

並列關鍵字

cellulitis ； necrotizing fasciitis ； debridement ； amputation

參考文獻

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一位49歲女性以反覆性右膝紅腫痛表現

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