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Lower-extremity soft tissue infections with intra-abdominal sources

机译:腹内来源下肢软组织感染

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This article describes a series of 3 patients who presented with lower-extremity soft tissue infections. Each patient was treated with prompt debridement by an orthopedic surgeon (J.F.G.) and required at least 1 additional procedure by another surgeon. These infections vary from superficial cellulitis to rapidly advancing necrotizing fasciitis. At times, the source of these infections is clear. Other times, no obvious source of infection exists, in which case the abdomen must be considered as a possible source of infection. A high level of suspicion, complete history and physical examination, and appropriate ancillary studies are required to make an accurate and prompt diagnosis. Options for the treatment of the intra-abdominal source of infection depend on the etiology of the infection and anatomic location of the process. Psoas abscesses can often be decompressed by an interventional radiologist using computed tomography guidance. In the case of bowel involvement, such as suspected carcinoma or diverticulitis, a general surgeon is necessary. When the appropriate diagnosis is made, soft tissue infections of the thigh often respond to appropriate surgical debridement and antibiotic therapy. It is important to remember the whole patient when evaluating soft tissue infections, especially in the thigh. A low threshold for imaging of the abdomen and pelvis is important, especially when the physical examination or medical history reveals the abdomen as a possible source of infection.
机译:本文介绍了3例下肢软组织感染的患者。骨科外科医生(J.F.G.)对每位患者进行了及时的清创治疗,并由另一位外科医生进行了至少一项额外的手术。这些感染从浅表性蜂窝组织炎到迅速发展的坏死性筋膜炎不等。有时,这些感染的来源很明确。其他时候,不存在明显的感染源,在这种情况下,必须将腹部视为可能的感染源。需要高度怀疑,完整的病史和体格检查,并进行适当的辅助研究才能做出准确而迅速的诊断。腹腔内感染源的治疗选择取决于感染的病因和过程的解剖位置。介入放射科医生通常可以使用计算机断层扫描指导对腰大肌脓肿进行减压。在肠受累的情况下,如疑似癌或憩室炎,必须由普通外科医师进行。做出适当的诊断后,大腿的软组织感染通常会对适当的外科清创术和抗生素治疗产生反应。在评估软组织感染时,尤其是在大腿部位,记住整个患者非常重要。腹部和骨盆成像的低阈值很重要,尤其是在体格检查或病史表明腹部可能是感染源的情况下。

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