Dermohypodermites bactériennes nécrosantes et fasciites nécrosantes : chez l’enfant aussi ! View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-07

AUTHORS

R. Blondé, J. Naudin, H. See, T. Galas, É. Bingen, S. Le Garrec, S. Dauger

ABSTRACT

Les dermohypodermites bactériennes nécrosantes associées ou non aux fasciites nécrosantes sont des infections bactériennes rares chez l’enfant. Parmi les facteurs de prédisposition, on retrouve la varicelle et les traumatismes. Il est important de reconnaître tôt ces infections avant l’apparition de complications, notamment l’extension des plages de nécrose et le choc septique. La prise en charge thérapeutique est médicochirurgicale et nécessite une hospitalisation dans une unité de réanimation pédiatrique. Pour les infections cervicales, périorbitaires et périnéales, l’imagerie par résonance magnétique et la tomodensitométrie peuvent apporter une aide intéressante pour déterminer l’extension de la nécrose dans les tissus profonds. Cependant, les indications doivent être discutées en fonction des territoires incriminés et le délai de réalisation ne doit pas retarder la prise en charge. Le streptocoque β-hémolytique du groupe A (Streptococcus pyogenes) est le microorganisme prépondérant de ces infections, bien que l’incidence de Staphylococcus aureus, sécréteur ou non de toxines, soit en constante augmentation. Le décès survient chez 5 à 20 % des patients. Le pronostic dépend de la précocité du diagnostic et de la rapidité de mise en route de l’antibiothérapie et du traitement chirurgical. Cette prise en charge multidisciplinaire en urgence est parfois difficile à organiser chez l’enfant, compte tenu de la rareté de ces infections. More... »

PAGES

427-438

Journal

TITLE

Médecine Intensive Réanimation

ISSUE

4

VOLUME

22

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s13546-013-0668-9

DOI

http://dx.doi.org/10.1007/s13546-013-0668-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1039327584


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