Barrera O Manuel, Rivera V Matías de la, Vela U Javier, Barrera M Rodrigo, Mönckeberg F Gustavo
Interno Medicina Universidad de los Andes, Santiago, Chile.
Clínica Universidad de los Andes, Santiago, Chile.
Rev Med Chil. 2018 Sep;146(9):1070-1073. doi: 10.4067/s0034-98872018000901070.
Vasculitic midline destructive lesions can be a complication of cocaine use. We report a 44-year-old man who presented with a two months history of left facial pain associated with ipsilateral facial paralysis and a cheek phlegmon. Magnetic resonance imaging showed broad soft tissue destruction linked to important cranial nerve involvement. Antibiotic and antifungal therapy was started and multiple surgical debridement procedures were performed, with no clinical improvement. Microbiological analysis was negative. Finally, thanks to the histologic findings corresponding to vasculitis and granuloma formation and the history of cocaine abuse, a cocaine induced midline destructive lesion was diagnosed.
血管炎性中线破坏性病变可能是可卡因使用的并发症。我们报告一名44岁男性，他有两个月的左侧面部疼痛病史，伴有同侧面部麻痹和颊部蜂窝织炎。磁共振成像显示广泛的软组织破坏，并伴有重要的颅神经受累。开始使用抗生素和抗真菌治疗，并进行了多次手术清创，但临床症状无改善。微生物学分析为阴性。最后，由于组织学检查结果符合血管炎和肉芽肿形成，且有可卡因滥用史，诊断为可卡因诱发的中线破坏性病变。
