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多微生物性牙源性眶周及眶部坏死性筋膜炎(PONF):一例报告。

Polymicrobial odontogenic periorbital and orbital necrotizing fasciitis (PONF): A case report.

作者信息

Mosenia Arman, Shahlaee Abtin, Giese Isaiah, Winn Bryan J

机构信息

Department of Ophthalmology, University of California San Francisco, 490 Illinois Street, San Francisco, CA, 94158, USA.

School of Medicine, University of California, San Francisco, 533 Parnassus Ave, San Francisco, CA, 94143, USA.

出版信息

Am J Ophthalmol Case Rep. 2022 Feb 18;26:101439. doi: 10.1016/j.ajoc.2022.101439. eCollection 2022 Jun.

Abstract

PURPOSE

To present a case of periorbital and orbital necrotizing fasciitis (PONF) from an odontogenic source with a distinct microbiologic profile and highlight the need for emergent multidisciplinary management.

OBSERVATIONS

A 39-year-old man presented with periorbital swelling, pain, and erythema following facial trauma. Imaging revealed peri-dental collections, accompanying maxillary sinusitis, and pre- and post-septal involvement. Immediate surgical debridement of necrotic tissue along with broad-spectrum antibiotics were pursued for management. Cultures grew multiple organisms, most notably group and .

CONCLUSIONS AND IMPORTANCE

PONF is a rare yet potentially fatal disease. group and a fulminant course are to be suspected when the source is odontogenic. Timely multidisciplinary surgical debridement and medical management with intravenous antibiotics is critical for best outcomes.

摘要

目的

报告一例源自牙源性的眶周及眶部坏死性筋膜炎(PONF)病例,其具有独特的微生物学特征,并强调紧急多学科管理的必要性。

观察结果

一名39岁男性在面部创伤后出现眶周肿胀、疼痛和红斑。影像学检查显示牙周间隙积液、伴上颌窦炎以及眶隔前后均受累。立即进行坏死组织的手术清创,并使用广谱抗生素进行治疗。培养出多种微生物,最显著的是 组和 组。

结论与重要性

PONF是一种罕见但可能致命的疾病。当病因是牙源性时,应怀疑 组和暴发性病程。及时进行多学科手术清创和静脉注射抗生素的药物治疗对于取得最佳治疗效果至关重要。

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