Pathogenese, Klassifikation und Diagnose der nekrotisierenden Weichteilinfektionen

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• 作者：Dr. S. Schnürer (1)
  J.P. Beier (1)
  R. Croner (2)
  R.J. Rieker (3)
  R.E. Horch (1)
  
• 关键词：Nekrotisierende Weichteilinfektionen ; Nekrotisierende Fasziitis ; Krepitationen ; Laboratory risk indicator for necrotizing fasciitis (LRINEC) ; Fournier ; Gangr?n ; Necrotizing soft tissue infection ; Necrotizing fasciitis ; Crepitation ; Laboratory risk indicator for necrotizing fasciitis (LRINEC) ; Fournier gangrene
• 刊名：Der Chirurg
• 出版年：2012
• 出版时间：November 2012
• 年：2012
• 卷：83
• 期：11
• 页码：943-952
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• 作者单位：Dr. S. Schnürer (1)
  J.P. Beier (1)
  R. Croner (2)
  R.J. Rieker (3)
  R.E. Horch (1)
  
  1. Plastisch- und Handchirurgische Klinik, Universit?tsklinikum Erlangen, Friedrich-Alexander-Universit?t Erlangen-Nürnberg, Krankenhausstr. 12, 91054, Erlangen, Deutschland
  2. Chirurgische Klinik, Universit?tsklinikum Erlangen, Friedrich-Alexander-Universit?t Erlangen-Nürnberg, Erlangen, Deutschland
  3. Pathologisches Institut, Universit?tsklinikum Erlangen, Friedrich-Alexander-Universit?t Erlangen-Nürnberg, Erlangen, Deutschland
  
• ISSN：1433-0385

文摘

Necrotizing soft tissue infections are caused by a variety of pathogens and may affect different types of soft tissue. Even today mortality and lethality are very high. The primary symptoms of necrotizing soft tissue infections are local pain out of proportion, swelling, erythema and crepitation in cases of subcutaneous gas. A systemic inflammatory response syndrome (SIRS) is often associated. During the last decades early recognition and initiation of an adequate therapy were able to reduce lethality to an average of 20%. The physical examination remains the diagnostic gold standard and may be supported by typical findings of imaging technologies, e.g. subcutaneous gas on x-rays and laboratory tests. After diagnosis an adequate antibiotic and surgical therapy should be performed immediately.