다양한 전신 질환을 수반한 괴사성 근막염의 증례

A CASE REPORT OF NECROTIZING FASCITIS ASSOCIATED WITH MULTIPLE SYSTEMIC DISORDERS

Necrotizing Fascitis is a relatively rare but specific clinical entity characterized by extensive necrosis of the superficial fascia with widespread undermining of surrounding tissue and extreme systemic toxicity. The upper and lower extermities are most commonly affected parts, but occurance in head and neck is rare, possibly because of the abundant vascularity of the region. It s treatment require aggressive therapy, such as wide incision and drainage, repeated surgical debridement, aggressive wound care, massive antibiotic therapy, resolving of associated disease and supportive treatment. Recently, we experienced a case of Necrotizing Fasciitis in Oral & Maxillofacial region. The patient was 68 year old female and was severe depressed defensive mechanism due to multiple systemic disturbance. Pathologic lesion appeared as widespread fascial necrosis, gangrene, crepitation and skin discoloration on the right side of face and submandibular region. Local surgical wound healing was successful but on the 55 days after admission, the patient eventually died because of gastrointestinal bleeding. The author conclude that the most importance in treatment of necrotizing fasciitis is elevation of host resitance by resolving of associated systemic disorders and support of multiple vital organ.