大胸筋皮弁による再建を要した頸部壊死性筋膜炎例 Cervical Necrotizing Fasciitis Requiring Surgical Reconstruction Using Pectoralis Major Myocutaneous Flap

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In an immuno-compromised host with systematically disordered immuno-function, a mild infectious disease of the head and neck occasionally becomes severe, developing to cervical necrotizing fasciitis (CNF). We reported a case of CNF in a 74-year-old woman with chronic nephritis, who had been taking adrenocorticosteroids for about 20 years. Conservative therapy using intravenous antibiotic agents, based on the initial diagnoses of buccal cellulitis and acute tonsillitis, was ineffective for cheek and tonsil symptoms. Consequently, a large clot originating from tonsillar hemorrhage led to respiratory arrest after 6 days in hospital. Intensive medical care in the ICU improved her respiration and consciousness level. However, the progressive lesion of the cheek and tonsil, which was finally diagnosed as CNF and treated by surgical debridement, formed a large pharyngocutaneous fistula after 9 days in hospital. The pathogenic bacteria were <i>Streptococcus milleni</i>, <i>Prevotella oris</i> and <i>Pseudomonas aeruginosa</i>. Two weeks later, the pharyngocutaneous fistula was closed by reconstructive surgery using a pectoralis major myocutaneous (PMMC) flap, indicating that this flap is appropriate to reconstruct a large pharyngeal and cervical defect with a poor environment for wound healing because of the rich muscle volume and stability of local blood flow.

収録刊行物

  • 耳鼻咽喉科臨床

    耳鼻咽喉科臨床 101(2), 87-93, 2008-02-01

    The Society of Practical Otolaryngology

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各種コード

  • NII論文ID(NAID)
    10021293858
  • NII書誌ID(NCID)
    AN00107089
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    00326313
  • NDL 記事登録ID
    9362594
  • NDL 雑誌分類
    ZS43(科学技術--医学--耳鼻咽喉科学)
  • NDL 請求記号
    Z19-421
  • データ提供元
    CJP書誌  NDL  J-STAGE 
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