Hohlweg-Majert Bettina, Weyer Nils, Metzger Marc C, Schön Ralf
Department of Oral and Maxillofacial Surgery, University Hospital Freiburg, Hugstetterstrasse 55, D-79106 Freiburg, Germany.
Diabetes Res Clin Pract. 2006 May;72(2):206-8. doi: 10.1016/j.diabres.2005.09.012. Epub 2006 Jan 30.
Cervical necrotizing fasciitis is a fast spreading acute soft tissue inflammation. Death can occur within 12-24 h. Early identification and treatment is needed. We report the case of a 75 year old woman with diabetes and high cholesterol, adipositas who developed cervical necrotizing fasciitis of odotongenic origin with massive subcutaneous air collection and first sign of septicaemia. Surgical treatment with debridement and drainage in combination with intravenous broadbased antibiotics as well as daily irrigation of the wound with iodine solution (Betaisodona) and metronidazol (local antibiotic treatment) was performed. The patient recovered completely. Surgical debridement combined with broad-spectrum of antibiotics showed satisfying result for the management of cervical necrotizing fasciitis of dentogenous origin.
颈部坏死性筋膜炎是一种迅速蔓延的急性软组织炎症。可在12至24小时内导致死亡。需要早期识别和治疗。我们报告一例75岁女性病例,该患者患有糖尿病、高胆固醇血症及肥胖症,发生了牙源性颈部坏死性筋膜炎,伴有大量皮下积气及败血症的首发症状。采用清创引流手术,并联合静脉使用广谱抗生素,以及每日用碘溶液(必舒碘)和甲硝唑冲洗伤口(局部抗生素治疗)。患者完全康复。手术清创联合广谱抗生素治疗牙源性颈部坏死性筋膜炎取得了满意的效果。