Letaler Verlauf einer fulminanten nekrotisierenden Fasziitis und Clostridium-perfringens-Infektion nach Resektion eines Weichteil-Sarkoms

Zusammenfassung

Vorgestellt wird der Fall eines 57-jährigen Patienten mit letalem Verlauf nach Resektion eines Myxofibrosarkoms am Oberschenkel. Auf dem Boden einer nekrotisierenden Fasziitis bei Mischinfektion von Staphylococcus lugdunensis und Clostridium perfringens mit Ausbildung ausgedehnter Myonekrosen kam es zu einem septischen Schock mit Hämolyse und Multiorganversagen. Die Autoren zeichnen den fulminanten Verlauf dieser sehr seltenen Komplikation nach onkologischer Resektion nach und diskutieren das chirurgische Vorgehen anhand aktueller Literatur.

Abstract

We present the case of a 57-year-old male patient with a fatal outcome after resection of a soft tissue sarcoma of the lateral thigh. A polymicrobial surgical site infection with Staphylococcus lugdunensis and Clostridium perfringens caused fulminant necrotising fasciitis with an additional gas gangrene. The patient suffered a severe sepsis with consecutive haemolysis and multiorgan failure. The authors recapitulate the deadly progress of a rarely reported complication after oncological resection. The therapeutic approach and surgical interventions are discussed based on the current literature.

Schlüsselwörter

Weichteilsarkom - nekrotisierende Fasziitis - Gangrän - postoperative Infektion

Key words

Soft tissue sarcoma - surgical site infection - necrotising fasciitis - gas gangrene

• Literatur

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