TAILIEUCHUNG - Báo cáo y học: " Necrotizing fasciitis following saphenofemoral junction ligation with long saphenous vein stripping: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Necrotizing fasciitis following saphenofemoral junction ligation with long saphenous vein stripping: a case report. | Smith et al. Journal of Medical Case Reports 2010 4 161 http content 4 1 161 jAl JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Necrotizing fasciitis following saphenofemoral junction ligation with long saphenous vein stripping a case report Stella Ruth Smith Moayad Aljarabah Graeme Ferguson Zahir Babar Abstract Introduction Necrotizing fasciitis is a rare condition with a mortality rate of around 34 . It can be mono- or polymicrobial in origin. Monomicrobial infections are usually due to group A streptococcus and their incidence is on the rise. They normally occur in healthy individuals with a history of trauma surgery or intravenous drug use. Post-operative necrotizing fasciitis is rare but accounts for 9 to 28 of all necrotizing fasciitis. The incidence of wound infection following saphenofemoral junction ligation and vein stripping is said to be less than 3 although this complication is probably under-reported. We describe a case of group A streptococcus necrotizing fasciitis following saphenofemoral junction ligation and vein stripping. Case Presentation A 39-year-old woman presented three days following a left sided saphenofemoral junction ligation with long saphenous vein stripping at another institution. She had a three day history of fever rigors and swelling of the left leg. She was pyrexial and shocked. She had a very tender swollen left groin and thigh with a small blister anteriorly and was in acute renal failure. She was prescribed intravenous penicillin and diagnosed with necrotizing fasciitis. She underwent extensive debridement of her left thigh and was commenced on clindamycin and imipenem. Post-operatively she required ventilatory and inotropic support with continuous veno-venous haemofiltration. An examination 12 hours after surgery showed no requirement for further debridement. A group A streptococcus sensitive to penicillin was isolated from the debrided tissue. A vacuum assisted closure device was .

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