Abdurrazaq T O, Ibikunle A A, Braimah R O
Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.
Ann Med Health Sci Res. 2016 Jul-Aug;6(4):251-256. doi: 10.4103/amhsr.amhsr_33_16.
Necrotizing fasciitis was recognized centuries ago by physicians. It is a rapidly progressive and potentially fatal soft-tissue infection that is typified by soft-tissue necrosis, especially affecting the subcutaneous tissues and fascia. Cervico-facial necrotizing fasciitis is said to be uncommon, but when it occurs, it is often of odontogenic origin and has severe consequences if not promptly treated. Possible underlying systemic diseases and the source of infection should be addressed and treated appropriately. We present two cases of extensive cervicofacial necrotizing fasciitis, one of which was idiopathic in origin and the other with gross involvement of the chest and abdominal walls. Both were treated successfully. Immediate resuscitation of the patients, administration of empirical antibiotics, treatment of underlying systemic conditions and early, aggressive and serial debridement were the bedrock of management in these cases.
坏死性筋膜炎早在几个世纪前就被医生所认识。它是一种迅速进展且可能致命的软组织感染,其典型特征是软组织坏死,尤其影响皮下组织和筋膜。颈面部坏死性筋膜炎据说是不常见的,但一旦发生,通常起源于牙源性,如果不及时治疗会产生严重后果。应找出并适当治疗可能存在的潜在全身性疾病和感染源。我们报告两例广泛的颈面部坏死性筋膜炎病例,其中一例病因不明,另一例胸腹壁严重受累。两例均成功治愈。患者的即刻复苏、经验性抗生素的使用、潜在全身性疾病的治疗以及早期、积极且连续的清创术是这些病例治疗的基础。