Necrotizing Fasciitis in Young Children-Two Case Reports

壞死性筋膜炎是種猛爆性且高致死率的疾病，甚少發生於幼兒，文獻報告常發生在健康小孩接受手術併發感染。在1997年本院經歷二例幼兒壞死性筋膜炎，二例均產生嚴重全身性症狀包括了高燒，頻脈，白血球過高，皮膚變化與迅速惡化的臨床過程。第一例發生在足部創傷造成敗血症，另一例則是箝塞性疝氣術後併發感染。細菌培養均是金黃色葡萄球菌，二例均於入院診斷後緊急清創。二例均存活而且無任何後遺症產生。幼兒壞死性筋膜炎治療主要在早期診斷，積極手術擴創，適當營養和體液補充與廣效性抗生素旳使用，以期提高存活率。

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並列摘要

Necrotizing fasciitis is a serious infection carrying fulminant course and high mortality rate. In grossly, necrotizing fasciitis usually presents as a postoperative complication, rarely appears following trauma or without apparent cause in grossly healthy infants. In mid-1997, we have experienced two cases of infant necrotizing fasciitis. Both patients presented with an altered sensorium and signs of systemic toxicity including fever, tachycardia, abnormal white blood cell counts, violaceous skin discoloration and rapid progression of clinical course. The first patient developed septic shock after minor trauma of lower leg and the other patient presented symptoms following emergent herniorrhaphy for incarcerated hernia. The isolated micro-organism were Staphylococcus aureus in both patients. Both patients underwent aggressive surgical debridement immediately. The cornerstones of the successful treatment are early and aggressive surgical debridement of the massive necrotic tissue, repeated debridement if necessary, adequate hydration and untritional support, and broad- spectrum antibiotics. Prompt recognition and aggressive therapy can improve the survival of necrotizing fasciitis in the patients of young children.

並列關鍵字

necrotizing fasciltis ； young children

國際替代計量

Necrotizing Fasciitis in Young Children-Two Case Reports

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