치성감염에 의한 광범위 괴사성 근막염 : 증례보고
Extensive necrotizing fasciitis owing to odontogenic infection : report of a case
오지현, 이정섭, 유재하,
소속 상세정보
오지현 ( Oh Ji-Hyeon ) - 연세대학교 원주세브란스기독병원 치과학교실
이정섭 ( Lee Jeong-Sub ) - 연세대학교 원주세브란스기독병원 치과학교실
유재하 ( Yoo Jae-Ha ) - 연세대학교 원주세브란스기독병원 치과학교실
KMID : 1033920160120010001
Abstract
Necrotizing fasciitis is characterized by widespread necrosis of the superficial fascia with extensive undermining of the
surrounding tissues. It occurs frequently in the abdominal wall, perineum and lower extremities after surgical operation or trauma, but the occurrence in head and neck region is rare, possibly because of the abundant vascularity of the area.
The involved microorganisms are represented by mixed synergistic infections involving both aerobes and anaerobes, such as, Staphylococcus aureus, Pseudomonas aeruginosa, Bacteroides melaninogenicus, and Klebsiella aerobactor.
The predisposing factors producing necrotic lesion are thought as the diabetes mellitus, atherosclerosis, alcoholism, drug
abuser, trauma and recent surgical operation in immunosuppressive states. It's treatment requires early recognition, prompt and aggressive surgical debridement, incision & drainage and proper supportive cares, such as, antibiotic therapy, fluid resuscitation and correction of metabolic and electrolyte disorder resolving of the underlying systemic disease.
The patient, 76-years-old, woman was diagnosed as acute buccal & cervical necrotizing faciitis by odontogenic infection
and it was successfully treated by early wide surgical debridement, consistent wound cleansing and drainage and
systemic supportive cares.
키워드
Incision & drainge; Mixed synergistic infection; Necrotizing fasciitis; Odontogenic infection; Wide surgical debridement
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