1Department of Chinese Medicine, Tri-Service General Hospital, National Defense Medical
Center, Taipei, Taiwan.
2Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine,
Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
3Division of Chinese Medicine, Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan.
【Summary】
Summary
Necrotizing fasciitis (NF) is a serious infectious disease that mainly invades subcutaneous tissue, fascia, and fat. If NF is not treated properly, it will cause severe sepsis, shock, and even death. This case is an 81-year-old female who has past history of hypertension, type 2 diabetes and ischemic stroke, and can still be able to walk with a walker. A week before admission, she fell accidentally and caused buttocks contusion. Symptoms such as shortness of breath accompanied by general weakness began to appear. When she was sent to the emergency department of our hospital, she developed respiratory failure and the skin on the right buttock was red and swollen with subcutaneous crepitations. After a series of examinations, she was diagnosed bilateral buttock necrotizing fasciitis. Surgery was indicated but the patient was conservatively treated because of the high risk from general anesthesia.
On the basis of Western medicine fluid supplementation, respirator assistance and antibiotic treatment, Chinese medicine is added to warm and nourish the spleen and kidney Yang-qi, so as to promote the operation of Ying-qi and Wei-qi and promote tissue repair. After two months of combined care with traditional Chinese and Western medicine, the patient’s wound recovered well and was discharged from the hospital smoothly. This combined care case shows that under the principles of TCM syndrome differentiation, seeking causes, examining causes and treating, TCM can also play a certain curative role on severe infectious diseases.