Necrotizing fasciitis of the chest wall: A clinical case report and literature review.
bronchopleural fistula
chest wall infection
necrotizing fasciitis
transcervical mediastinoscopic bronchial closure
tuberculous destroyed lung
Journal
Experimental and therapeutic medicine
ISSN: 1792-1015
Titre abrégé: Exp Ther Med
Pays: Greece
ID NLM: 101531947
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
10
09
2021
accepted:
11
10
2021
entrez:
22
12
2021
pubmed:
23
12
2021
medline:
23
12
2021
Statut:
ppublish
Résumé
Necrotizing fasciitis of the chest wall is a very rare pathology, but with significant mortality, representing a therapeutic challenge. All international reports indicate the need for early diagnosis and an aggressive medical-surgical attitude in order to improve the prognosis. In addition to a review of literature, we present a case developed secondary to a thoracic pleural drainage for pyopneumothorax associated with significant bronchopleural fistula in a destroyed tuberculous left lung. Along with medical treatment, extensive surgical debridement was required. Despite drainage incisions and negative pressure wound therapy (NPWT), the evolution of the fasciitis was difficult, due to bronchopleurocutaneous fistula. Thus, the Azorin procedure (transcervical mediastinoscopic closure of the left main bronchus) was performed. Once this procedure was completed, the inflammatory phenomena were controlled which allowed for a second step consisting of left pneumonectomy, with the application of specific methods for the prevention of bronchial fistula. The clinical case was a therapeutic challenge requiring a complex, staged, multidisciplinary approach due to both the immunocompromised terrain and the severity of the lesions. In conclusion, early recognition and aggressive and combined application of medical and surgical treatment methods can ensure therapeutic success.
Identifiants
pubmed: 34934455
doi: 10.3892/etm.2021.11013
pii: ETM-0-0-11013
pmc: PMC8652382
doi:
Types de publication
Case Reports
Langues
eng
Pagination
90Informations de copyright
Copyright: © Petreanu et al.
Déclaration de conflit d'intérêts
The authors declare they have no competing interests.
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