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患者女,50岁。发热及全身皮下结节、水疱10天入院,既往左侧乳腺癌手术及化疗后1月。入院后血培养及水疱破溃处分泌物培养均提示铜绿假单胞菌感染。皮损组织病理示:真皮深部部分皮下脂肪液化坏死,脂肪间隔及小叶内血管周围见大量淋巴单一核细胞浸润,脂肪内可见中小血管栓塞,管壁变性坏死。入院诊断败血症合并感染性脂膜炎,治疗上予抗感染、丙种球蛋白提高免疫等对症支持治疗,好转后出院。
Female patient, 50 years old. Fever and systemic subcutaneous nodules, blisters admitted for 10 days, previous left breast cancer surgery and chemotherapy after January. After admission, blood culture and blister rupture secretions were prompted Pseudomonas aeruginosa infection. Histopathological examination showed that subcutaneous fat was liquefied and necrotic in the deep part of the dermis. A large number of infiltrating mononuclear cells infiltrated in the fat septum and perivascular blood vessels. Small or medium blood vessel embolism was found in the fat, and the wall degeneration and necrosis. Admission diagnosis of sepsis with infectious panniculitis, the treatment of anti-infection, immunoglobulin gamma immune symptomatic and supportive treatment, improved after discharge.