Lopez-Fernandez Rubi, Ramirez-Melgoza Jorge, Martinez-Aguilar Nora Ernestina, Leon-Chavez Alicia, Martinez-Fong Daniel, Gonzalez-Barrios Juan Antonio
Laboratorio de Medicina Genómica, Hospital Regional "1o, de Octubre", Av, IPN No, 1669, México D, F,, C,P, 07760, México.
J Med Case Rep. 2011 Mar 11;5:98. doi: 10.1186/1752-1947-5-98.
Odontogenic necrotizing fasciitis of the neck is a fulminant infection of odontogenic origin that quickly spreads along the fascial planes and results in necrosis of the affected tissues. It is usually polymicrobial, occurs frequently in immunocompromised patients, and has a high mortality rate.
A 69-year old Mexican male had a pain in the maxillar right-canine region and a swelling of the submental and submandibular regions. Our examination revealed local pain, tachycardia, hyperthermia (39°C), and the swelling of bilateral submental and submandibular regions, which also were erythematous, hyperthermic, crepitant, and with a positive Godet sign. Mobility and third-degree caries were seen in the right mandibular canine. Bacteriological cultures isolated streptococcus pyogenes and staphylococcus aureus. The histopathological diagnosis was odontogenic necrotizing fasciitis of the submental and submandibular regions. The initial treatment was surgical debridement and the administration of antibiotics. After cultures were negative, the surgical wound was treated with a growth factor-enriched autologous plasma eight times every third day until complete healing occurred.
The treatment with a growth factor-enriched autologous plasma caused a rapid healing of an extensive surgical wound in a patient with odontogenic necrotizing fasciitis. The benefits were rapid tissue regeneration, an aesthetic and a functional scar, and the avoidance of further surgery and possible complications.
颈部牙源性坏死性筋膜炎是一种牙源性暴发性感染，可沿筋膜平面迅速蔓延，导致受累组织坏死。它通常是多微生物感染，常见于免疫功能低下的患者，死亡率很高。
一名69岁的墨西哥男性，上颌右尖牙区疼痛，颏下和下颌下区域肿胀。我们的检查发现局部疼痛、心动过速、体温过高（39°C），双侧颏下和下颌下区域肿胀，这些区域还出现红斑、发热、捻发音，戈代征阳性。右侧下颌尖牙可见松动和三度龋齿。细菌培养分离出化脓性链球菌和金黄色葡萄球菌。组织病理学诊断为颏下和下颌下区域牙源性坏死性筋膜炎。初始治疗为手术清创和使用抗生素。培养结果为阴性后，每隔三天用富含生长因子的自体血浆治疗手术伤口八次，直至完全愈合。
用富含生长因子的自体血浆治疗，使一名牙源性坏死性筋膜炎患者的大面积手术伤口迅速愈合。其益处包括组织快速再生、形成美观且功能良好的瘢痕，以及避免进一步手术和可能的并发症。
