Schurr Christian, Burghartz M, Miethke T, Kesting M, Hoang N, Staudenmaier R
Klinik für Hals-Nasen-Ohren-Heilkunde, Technische Universität München, Munich, Germany.
Eur Arch Otorhinolaryngol. 2009 Mar;266(3):325-31. doi: 10.1007/s00405-008-0870-y. Epub 2008 Nov 29.
Necrotizing fasciitis is a progressive, life-threatening, bacterial infection of the skin, the subcutaneous tissue and the underlying fascia, in most cases caused by ss-hemolytic group A streptococcus. Only early diagnosis and aggressive therapy including broad spectrum antibiotics and surgical intervention can avoid systemic toxicity with a high mortality rate. This uncommon disease generally occurs in the lower extremities and trunk, and only rarely affects the head and neck region. When located in the face necrotizing fasciitis is associated with severe cosmetic and functional restrictions due to the invasive infection and often to the necessary surgical treatment. Generally surgical intervention cannot be performed in the face as aggressively as in the extremities and trunk, since a lot of vital structures are found in a relatively small area. In the following article, we present the successful diagnostic and therapeutic management of an isolated facial necrotizing fasciitis as a consequence of a nasal bone fracture with a minor dermal cut.
坏死性筋膜炎是一种进行性、危及生命的皮肤、皮下组织及深部筋膜的细菌感染,多数情况下由A组β溶血性链球菌引起。只有早期诊断并采取包括广谱抗生素和手术干预在内的积极治疗,才能避免出现具有高死亡率的全身毒性反应。这种罕见疾病通常发生在下肢和躯干,很少累及头颈部区域。当位于面部时,坏死性筋膜炎由于侵袭性感染以及通常所需的手术治疗,会导致严重的外观和功能受限。一般来说,面部手术干预无法像在四肢和躯干那样积极进行,因为在相对较小的区域内存在许多重要结构。在接下来的文章中,我们将介绍一例因鼻骨骨折伴轻微皮肤划伤导致的孤立性面部坏死性筋膜炎的成功诊断和治疗过程。