• Title/Summary/Keyword: 괴사 근막염

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Idiopathic Necrotizing Fasciitis in the Chest Wall -A case report- (흉벽에 발생한 특발성 괴사성 근막염 -1례 보고-)

  • 김병호;허동명
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.991-994
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    • 2000
  • 괴사성 근막염은 흔하지 않은 질환으로서 때로 전격적인 진행을 보이며 흉벽에 생기는 경우에는 매우 드물다. 신체의 어느 부위나 생길 수 있으나 주로 복벽이나 서혜부, 사지 등에 가장 많이 발생한다. 이 질환의 특징은 근막의 괴사가 광범위하게 진행되지만 피부나 근육은 비교적 잘 보존되어 있다. 따라서 조기에 진단하기가 어려우므로 진찰당시 이 질환을 염두에 두어야 진단할 수 있다. 조기진단 후 즉각적인 외과적 치료가 가장 중요하다. 본 병원 흉부외과에서 흉벽에 발생한 특발성 괴사성 근막염을 한 례 경험하여 치료하였기에 문헌 고찰과 함께 보고하는 바이다.

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CERVICOFACIAL NECROTIZING FASCIITIS;CASE REPORT (경안면 괴사성 근막염;증례보고)

  • Park, Kwan-Soo;Jeong, Ki-Hoon;Kim, Hyo-Eon;Jeong, Jeong-Kwon;Yoon, Kyu-Ho;Jeon, In-Seong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.1
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    • pp.77-81
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    • 2001
  • Necrotizing fasciitis is defined as infectious disease showing extensive necrosis of the superficial fascia with widespread involvement of the surrounding tissues and concurrent systemic toxicity. It is found commonly in the extremities, the trunk and the perineum, but shows extremely rare occurrence in the well vascularized area such as head and neck area. Occurred in the head and neck area, it is called "cervicofacial necrotizing fasciitis" (CFNF). It is a fatal disease which carries a mortality rate up to 60%. Early diagnosis, aggressive surgical debridement of necrotic tissues and massive antibiotics therapy are essential for achieving a favorable outcome. We present a case of cervicofacial necrotizing fasciitis in 35-year-old male patient with literature review.

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Three cases of atypically presented group A streptococcal infections (전형적인 전구 증상 없이 발현된 A군 연구균 감염증 3례)

  • Yeo, Yun Ku;Lee, Eun Hee;Ko, Kwang Min;Jae, Seo Jin;Kim, Tae Yeon;Lee, Jin;Kim, Yun Kyung
    • Pediatric Infection and Vaccine
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    • v.14 no.1
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    • pp.104-110
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    • 2007
  • Streptococcus pyogenes, which is classified to Group A streptococcus (GAS), is one of the most common bacterial pathogens of the childhood infection. This organism can cause acute bacterial pharyngitis, impetigo, peritonsilar abscess or scarlet fever. It can also cause severe invasive diseases such as toxic shock syndrome, sepsis, septic arthritis, necrotizing pneumonia or necrotizing fasciitis. Usually, invasive GAS infections are accompanied by systemic symptoms and signs. Necrotizing pneumonia presents with acute fever, pleuritic chest pain and cough. The progress of disease is usually rapid and typically, pleural effusion develops in the early course of disease. Necrotizing fasciitis is relatively rare but once it has developed, it may be life threatening and cause necrosis of adjacent soft tissues with rapid progress. Clinical manifestations of parapharyngeal abscess are fever, dysphagia or bulging of pharyngeal wall. We experienced three cases of GAS infections which were presented atypically.

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A Clinical Aspect Analysis of the Cervical Necrotizing Fasciitis (경부에 발생한 괴사성 근막염에 대한 임상적 양상 분석)

  • Yang, Jeong Hwan;Choi, Hyo Geun;Lee, Ju Han;Park, Bumjung
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.223-228
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    • 2018
  • Background and Objectives : Necortizing fasciitis in the cervical region is a very rare disease with high mortality and morbidity rates. The purpose of this study was to analyze the clinical characteristics, treatment results, complication and prognosis of necrotizing fasciitis patients. Materials and Methods : We retrospectively reviewed the inpatient charts treated for cervical necrotizing fasciitis at our Otorhinolaryngology clinic. We diagnosed necrotizing fasciitis by the clinical findings such as swelling, redness and pain of infected area and necrosis of subcutaneous fat layer and fascia observed during surgery. Twenty such patients were identified and treated from January 2011 to December 2016. Results : 20 adults consisting of 14 male and 6 females with cervical necrotizing fasciitis were diagnosed and treated. The most commonly known associated preceding illness were dental abscess and tonsillitis. The most pathogen was Streptococcus species (12/20), followed by Klebsiella pneumonia (6/20), Staphylococcus species (2/20). The mean duration of hospitalization was 32.2 days (range,14-86). The mean Modified Laboroatory Risk Indicator for Necrotizing Fasciitis (M-LRINEC) score is 7.4 and more than 4 points was eighteen. All patients received parenteral antibiotics and surgical drainage after admission. Conclusions : The reason for the high survival rate in the study was the early diagnosis, as well as the early surgical procedure and antibiotics. After the operation, frequent betadine irrigation could improve the patient's condition and recover without severe complication.

Klebsiella Pneumonia-Necrotizing Fasciitis followed by Liver Abscess (폐렴 간균-괴사성 근막염에 이어 발생한 간농양)

  • Lee, Seung Hyun;Choi, Jeong Woo;Lee, Myeung Su
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.427-431
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    • 2018
  • We report a case of a patient with necrotizing fasciitis followed by liver abscess. A 51-year-old man was admitted to our hospital with a 5-day history of fever and chills with painful swelling of the right thigh. A magnetic resonance imaging (MRI) scan showed fluid collection with numerous dark signal intensities considered as air-bubbles between the posteromedial and posterolateral groups of the right thigh, resulting in presumptive diagnosis of necrotizing fasciitis. At the time of admission, an ultrasonograph of the abdomen showed increased parenchymal echogenicity of both kidneys and no liver abscess. Ten days after fasciotomy, an abdominal computed tomography (CT) scan showed intrahepatic abscess. Sonography-guided percutaneous drainage was performed. Both cultures of pus specimens from the liver abscess and right thigh yielded Klebsiella pneumoniae (K. pneumoniae). The patient was treated with fasciotomy several times and parenteral antibiotics, after which he began to improve. After 5 weeks, liver abscess size was reduced, and after 10 weeks, liver abscess disappeared. To the best of our knowledge, this is the first case of K. pneumoniae-necrotizing fasciitis followed by liver abscess.

Cranio-Cervico-facial Necrotizing fasciitis (두경 안면부 괴사성 근막염 : 증례보고)

  • Kim, Il-Kyu;Yang, Dong-Hwan;Choi, Jin-Ho;Oh, Nam-Sik;Kim, Wang-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.74-80
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    • 2002
  • Necrotizing fasciitis is rare acute infection showing rapidly necrosis involve the subcutaneous tissue and fascia. If treatment is delayed, infection can spread to involve the subcutaneous tissue, skin, deep fascia, and even muscle in rapid sequence, resulting in widespread necrosis and moderate to severe systemic toxicity. Most commonly this disease presents in the extremities, trunk, and perineum; it is relatively rare in the head and neck regions. If not diagnosed and treated in its early stages, necrotizing fasciitis can be potentially fatal, with a motality rate approaching 40%. Historically, the clinical entity now referred to as necrotizing fasciitis was described in the literature under various name. : hospital gangrene, necrotizing erysipelas, streptococcal gangrene, suppurative fasciitis. Necrotizing fasciitis was first described by Wilson in 1952. We experienced 3 cases of necrotizing fasciitis and will report review of literature with diagnosis, treatment, complication and consideration.

NECROTIZING FASCIITIS OF HEAD AND NECK AREA : 4 CASES REPORTS (두경부 영역에 발생한 괴사성 근막염: 증례보고)

  • Seo, Woon-Kyung;Lee, Won;Han, Hyung-Uck;Go, Taek-Su;Park, Su-Hyun;Kim, In-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.6
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    • pp.580-587
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    • 2006
  • Necrotizing fasciitis has been recognized as a potentially lethal and rapidly progressing infection. Necrotizing fasciitis of head and neck area is rare but fatal disease that should be prompt diagnosis and recognition. If not promptly recognized and treated, infection can spread into the deep spaces of the neck and compromise the airway. It may also spread into the mediastimum producing life threatening sepsis. In this report, we describe the treatment of 4 cases of necrotizing fasciitis of head and neck area and discuss diagnosis, treatment, complication and consideration with review of literatures.

Atypical Type of Descending Necrotizing Fasciitis Spreading into the Lateral Chest Wall: Case Report (흉벽 외측을 타고 내려온 비전형성 하행 경부 괴사성 근막염 1예)

  • Lee, Yong Jik;Lee, Jong Cheol;Lee, Ho Min;Kim, Jung Won;Jung, Jong Phil;Park, Chang Ryul
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.61-64
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    • 2011
  • Cervical necrotizing fasciitis is a rare but well known life-threatening soft tissue infection primarily affecting the superficial and deep cervial fascial planes. It may rapidly spread into the mediastinum along fascial planes. So, if proper diagnosis and prompt surgical debridement is delayed, the infection may cause descending necrotizing mediastinitis with extensive necrosis of overlying skin, destroying fascia and muscle. Therefore, the key to the successful outcome is early recognition and rapid initiation of definitive radical debridement. The authors report, along with a literature review, a case of cervical necrotizing fasciitis with atypical spreading into the lateral chest wall.

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A Case of Necrotizing Fasciitis of Lower Leg Following Mandible Angle Ostectomy (턱벼각 절골술 후 발생한 괴사근막염의 치험례)

  • Lee, Won;Kang, Sang Yoon;Hong, Sung Kwan;Lee, Seung Ryong;Cho, Sang Hun;Han, Byung Kee
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.663-666
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    • 2005
  • Mandible angle ostectomy is the most widely-operated facial contour surgery. We experienced a rare case of necrotizing fasciitis of the lower leg following mandible angle ostectomy. A 20 years old female visited our department 5 days after mandible angle ostectomy. At the time, she was diagnosed as sepsis and on her 2nd admission day, she was diagnosed as necrotizing fasciitis on her left leg. She was treated by fasciotomy and necrotized tissue removal. Necrotizing fasciitis is a rare complication of any kinds of operation but once it develops, it causes fatal results, especially to cosmetic surgeries. Early diagnosis and aggressive operation is known as only treatment for the disease.