Title: Necrotizing Fasciitis
题目：坏死性筋膜炎
Author 作者: Haney Mallemat

Necrotizing fasciitis (NF) is a rapidly progressive bacterial infection of the fascia with secondary necrosis of the subcutaneous tissue. In severe cases, the underlying muscle (i.e., myositis) may be affected.
坏死性筋膜炎（NF）是一种快速进展的细菌性筋膜感染，伴之而来的是继发性皮下组织坏死。在严重的情况下，下面的肌肉（即，肌炎）可能受到影响。
Risk factors for NF include immunosuppression (e.g., transplant patients), HIV/AIDS, diabetes, etc.
NF的风险因素包括免疫抑制剂的应用（例如，器官移植患者），艾滋病毒感染/艾滋病，糖尿病等。
There are three categories of NF:
NF有三型：
Type I (poly-microbial infections)
•I型（多微生物感染）
Type II (Group A streptococcus; sometimes referred to as the “flesh-eating bacteria)
•II型（A组链球菌，有时也被称为“食肉菌）
Type III (Clostridial myonecrosis; known as gas gangrene)
•III型（梭菌性肌坏死, 被称为气性坏疽）
In the early stage of disease, diagnosis may be difficult; the physical exam sometimes does not reflect the severity of disease. Labs may be non-specific, but CT or MRI is important to diagnose and define the extent of the disease when planning surgical debridement.
在疾病的早期阶段，诊断可能是困难的; 体检有时并不反映疾病的严重程度。实验室检查可能会不特异，但CT或MRI对诊断和判断需要进行外科清创的疾病范围是重要的 。
Treatment should be aggressive and started as soon as the disease is suspected; this includes:
治疗要积极，一旦怀疑此病就要开始，包括：
Aggressive fluid and/or vasopressor therapy
积极液体治疗和/或升压药治疗
Broad spectrum antibiotics covering for gram-positive, gram-negative, and anaerobic bacteria; clindamycin should be added initially as it suppresses certain bacterial toxin formation
最初，应用对革兰氏阳性，革兰氏阴性菌和厌氧菌都敏感的广谱抗生素；同时要加用克林霉素，因为它可抑制某些细菌毒素的产生
Emergent surgical consult for debridement
紧急外科会诊，准备清创手术
Once the patient is stable, other treatments may include intravenous immunoglobulin and hyperbaric oxygen therapy
一旦患者病情稳定，其他治疗应包括静脉注射免疫球蛋白和高压氧治疗