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一名患有被忽视的扁桃体周围脓肿的患者发生颈坏死性筋膜炎和下行性坏死性纵隔炎:一例医疗过失案例

Cervical necrotizing fasciitis and descending necrotizing mediastinitis in a patient affected by neglected peritonsillar abscess: a case of medical negligence.

作者信息

Bono Giovanna, Argo Antonina, Zerbo Stefania, Triolo Valentina, Procaccianti Paolo

机构信息

Department of Legal Medicine, University of Palermo, Via Del Vespro, 127-90129 Palermo, Italy.

出版信息

J Forensic Leg Med. 2008 Aug;15(6):391-4. doi: 10.1016/j.jflm.2007.12.008. Epub 2008 Mar 18.

Abstract

We report a case of fatal cervical necrotizing fasciitis (CNF) and descending necrotizing mediastinitis (DNM) due to primary peritonsillar abscess in 60-year-old male patient with no history or evidence of immunocompromising disorders. The patient was treated with antibiotic and corticosteroid drugs but he developed mediastinitis and septic shock and died of multiple organ failure six days later from recovery in hospital. After a clinical, diagnostic and therapeutical consideration of the cervical necrotizing fasciitis and some related risks of a delayed diagnosis and treatment, the authors analysed the clinical history of the patient and of the medical conduct pointing out professional malpractice chargeable to doctors.

摘要

我们报告了一例60岁男性患者因原发性扁桃体周围脓肿导致致命性颈坏死性筋膜炎(CNF)和下行性坏死性纵隔炎(DNM)的病例,该患者无免疫功能低下疾病史或相关证据。患者接受了抗生素和皮质类固醇药物治疗,但仍发生了纵隔炎和感染性休克,住院六天后因多器官功能衰竭死亡,未能康复。在对颈坏死性筋膜炎进行临床、诊断和治疗方面的考量以及对延迟诊断和治疗的一些相关风险进行评估后,作者分析了该患者的临床病史及医疗行为,指出医生存在可归咎的医疗过失。

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