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面部坏死性筋膜炎:一种危及生命的疾病。

Necrotizing fasciitis of the face: a life-threatening condition.

机构信息

Department of Internal Medicine, University Hospital of Palermo, Palermo, Italy.

出版信息

Aging Clin Exp Res. 2009 Aug-Oct;21(4-5):358-62. doi: 10.1007/BF03324928.

Abstract

Necrotizing fasciitis (NF) is a highly aggressive infectious process, polymicrobial in nature, involving soft tissues with a high risk of rapid spread through superficial and deep fascial planes and muscular layers. Cervical NF is quite rare, is mostly of odontogenic origin, and may be complicated by descendant mediastinitis with a very high mortality rate. Systemic conditions impairing the patient's immune competence, such as diabetes, may play a predisposing role. An effective treatment strategy includes prompt diagnosis (clinical findings, local microbiological tests, blood culture and, if deemed necessary, histopathology), broad-spectrum antibiotic therapy as early as possible which should be later adjusted according to antibiogram results, stabilization of vital functions and, if possible, elimination/ treatment of predisposing factors. This paper describes a complex and emblematic case.

摘要

坏死性筋膜炎(NF)是一种高度侵袭性的感染性疾病,其本质为多种微生物感染,涉及软组织,具有通过浅筋膜和深筋膜平面以及肌肉层迅速扩散的高风险。颈部 NF 非常罕见,主要来源于牙源性感染,可能并发下行性纵隔炎,死亡率非常高。损害患者免疫能力的全身性疾病,如糖尿病,可能具有诱发作用。一种有效的治疗策略包括及时诊断(临床发现、局部微生物学检查、血培养,如有必要,还可进行组织病理学检查)、尽早开始广谱抗生素治疗,之后根据药敏试验结果进行调整,稳定生命体征,尽可能消除/治疗诱发因素。本文描述了一个复杂而典型的病例。

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