경부의 괴사성 근막염 치험례

Cervical necrotizing faciitis : report of a case

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 surgery 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 surgery in immunosuppressive states. It s treatment requires early recognition, prompt and aggressive surgical debridement 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, 57-year-old man, was diagnosed as acute 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.