蜂窝织炎的诊断通常依据临床表现。不到10%的患者的血培养结果呈阳性,若诊断不明确,可能需要皮肤活检,其标本培养的病原体检出率为20%-30%。链球菌溶血素O是A组链球菌(group A streptococcus,GAS)释放的一种溶细胞素,宿主体内针对此抗原的抗体增加,测定此抗体可用作诊断性检查。该患者曾创面分泌物培养阳性,且抗“O”阳性及脓液拭子NGS结果,均支持化脓性链球菌感染。
[1] Stevens DL, Bisno AL, Chambers HF, etal. Practice guidelines for the diagnosis and management of skin and softtissue infections: 2014 update by the infectious diseases society of America.Clin Infect Dis 2014; 59:147.
[2] Raff AB, Kroshinsky D. Cellulitis: AReview. JAMA 2016; 316:325.
[3] Crisp JG, Takhar SS, Moran GJ, et al.Inability of polymerase chain reaction, pyrosequencing, and culture of infectedand uninfected site skin biopsy specimens to identify the cause of cellulitis.Clin Infect Dis 2015; 61:1679.
[4] Mackie SL, Keat A. Poststreptococcalreactive arthritis: what is it and how do we know? Rheumatology (Oxford) 2004;43:949.