Klinički entiteti infektivne gangrene
| Autor: | Tomislav Bruketa, Ivan Puljiz |
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| Jazyk: | chorvatština |
| Rok vydání: | 2014 |
| Předmět: | |
| Zdroj: | Infektološki glasnik Volume 34 Issue 1 |
| ISSN: | 1848-7769 1331-2820 |
| Popis: | Infektivne gangrene ili nekrotizirajuće infekcije mekih česti su teške infekcije potkožnog tkiva s visokim mortalitetom. Infekciji najčešće prethodi kirurški tretman ili trauma. Postoje brojne klasifikacije infektivnih gangrena, a u praksi je uobičajena mikrobiološka podjela na tip I (polimikrobni) i tip II (uzrokovan streptokokom). Klinička slika infektivne gangrene uključuje intezivnu bol u području rane, krepitacije, prisutnu sekreciju, pojavu bula i brzi razvoj septičkog šoka. Vanjski izgled rane nerijetko ne korelira s stvarnim stanjem te može biti razlogom za kasnu dijagnozu. Dijagnoza bolesti postavlja se temeljem kliničke slike, laboratorijskih nalaza, radioloških pretraga, mikrobioloških nalaza, a potvrđuje i kirurškom ekploracijom zahvaćenog područja koja je i terapijski postupak. Pojava plina u mekim tkivima je tipičan znak za nekrotizirajuće infekcije i indicira početak liječenja. Izostanak pravovremene i agresivne terapije najčešće dovodi do nepovoljnog ishoda bolesti. Liječenje se sastoji od brze i ekstenzivne kirurške ekploracije i odstranjena nekrotičnih masa, kombinirane antibiotske terapije, te potrebite simptomatske i suportivne terapije. Infectious gangrenes or necrotizing soft tissue infections are severe subcutaneous tissue infections with high mortality rates. Infections are often preceded by a surgical procedure or trauma. There are many classifications of infectious gangrenes, however the most commonly used in practice is microbiological classification into type I (polymicrobial) and type II (caused by Streptococcus). The clinical presentation of infectious gangrene includes intense pain in the wound area, crepitations, secretion, the occurrence of bullae and rapid development of septic shock. The external appearance of the wound often does not correlate with the actual condition and may be the reason for late diagnosis. The diagnosis of the disease is based on clinical features, laboratory findings, radiological examinations, microbiological results, and is confirmed by surgical exploration of the affected area which is also a therapeutic procedure. Gas formation in the soft tissues is a typical sign of necrotizing infections and indicates the beginning of treatment. Lack of timely and aggressive treatment usually leads to poor disease outcome. Optimal treatment consists of prompt and extensive surgical wound exploration and necrotic tissue removal, combined antibiotic therapy and necessary symptomatic and supportive therapy. |
| Databáze: | OpenAIRE |
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