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化脓性链球菌引起的眶周坏死性筋膜炎:一例报告及解读

Periorbital Necrotizing Fasciitis Induced by Streptococcus pyogenes: A Case Report and Clarification.

作者信息

Deneubourg Dorothée L, Catherine Zulma, Lejuste Patrice, Breton Pierre

机构信息

Fellow, Division of Stomatology, Maxillo-Facial and Plastic Surgery, Centre Hospitalier Lyon Sud, Pierre Bénite, France.

Fellow, Division of Stomatology, Maxillo-Facial and Plastic Surgery, Centre Hospitalier Lyon Sud, Pierre Bénite, France.

出版信息

J Oral Maxillofac Surg. 2018 Jan;76(1):154.e1-154.e5. doi: 10.1016/j.joms.2017.09.004. Epub 2017 Sep 11.

Abstract

Periorbital necrotizing fasciitis (PONF) is a rare condition of the face. PONF can lead to blindness, functional and esthetic sequelae, multiple-organ failure, and death. The aim of this report is to raise the awareness of this severe condition in maxillofacial surgeons. This report describes the case of a 30-year-old woman who presented with a bilateral palpebral edema and pain 3 days after a jugal wound was sutured. Necrosis of the skin of the left palpebral unit was extending rapidly. The patient had signs of sepsis. Surgical debridement was performed promptly and intravenous broad-spectrum empiric antibiotics were administered. The patient recovered slowly with no complication other than a residual skin defect of the 2 eyelids that was later corrected by full-thickness skin grafting. Special attention should be paid to signs of preseptal cellulitis because it can, in some cases, rapidly develop into PONF. Early diagnosis and treatment are the keys to a favorable outcome.

摘要

眶周坏死性筋膜炎(PONF)是一种罕见的面部疾病。PONF可导致失明、功能和美学后遗症、多器官功能衰竭及死亡。本报告的目的是提高颌面外科医生对这种严重疾病的认识。本报告描述了一名30岁女性的病例,该患者在颧部伤口缝合3天后出现双侧眼睑水肿和疼痛。左眼睑部皮肤坏死迅速蔓延。患者有败血症迹象。立即进行了手术清创,并给予静脉注射广谱经验性抗生素。患者恢复缓慢,除双眼睑残留皮肤缺损外无其他并发症,该缺损后来通过全厚皮片移植得到纠正。应特别注意眶隔前蜂窝织炎的体征,因为在某些情况下,它可迅速发展为PONF。早期诊断和治疗是取得良好预后的关键。

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