Early Diagnosis and Surgical Management of Cervical Necrotizing Fasciitis Caused By Pseudomonas Aeruginosa: A Case Report

Tesa Renjani, Eka Marwansyah Oli’i, D. Maifara
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Abstract

Introduction: Necrotizing Fasciitis also known as flesh eating disease, is a rare, dangerous, and life threatening infection that causes extensive necrosis of muscle, fascia, subcutaneous, dermis, and epidermis tissue along fascial planes with or without overlying cellulitis. Case Report: We report a case of Necrotizing Fasciitis in a 37 year old woman who presented with swelling and neck pain for 7 days. Wound cultured showed Pseudomonas Aeruginosa. Pseudomonas aeruginosa as the culprit in Necrotizing Fasciitis of the neck region is rare and potentially fatal. Odontogenic infections are one of the reasons why this bacteria exists. Under general anesthesia, the patient underwent necrotomy debridement and tooth extraction. To date, the patient has undergone a second necrotomy debridement and closed with anterolateral thigh (ALT) free flap. The study highlights the importance of early intervention to improve outcomes. Conclusion: Treatment for this patient was necrotomy debridement and ATL free flap closure. Early detection, necrotomy debridement, and broad-spectrum antibiotic can reduce mortality and morbidity in Necrotizing Fasciitis. Keyword: Necrotizing Fasciitis, Necrotomy Debridement, Pseudomonas Aeruginosa
绿脓杆菌引起的颈椎坏死性筋膜炎的早期诊断和手术治疗:病例报告
简介坏死性筋膜炎又称食肉病,是一种罕见、危险且危及生命的感染,会导致肌肉、筋膜、皮下、真皮和表皮组织沿筋膜平面大面积坏死,伴有或不伴有上覆蜂窝组织炎。病例报告:我们报告了一例坏死性筋膜炎病例,患者是一名 37 岁女性,出现肿胀和颈部疼痛 7 天。伤口培养显示为绿脓杆菌。铜绿假单胞菌作为颈部坏死性筋膜炎的罪魁祸首十分罕见,而且可能致命。牙源性感染是这种细菌存在的原因之一。在全身麻醉下,患者接受了坏死性清创和拔牙手术。迄今为止,患者已接受了第二次坏死清创术,并用大腿前外侧(ALT)游离皮瓣进行了缝合。该研究强调了早期干预对改善预后的重要性。结论:该患者的治疗方法是坏死清创术和大腿前外侧游离皮瓣闭合术。早期发现、坏死清创和广谱抗生素可降低坏死性筋膜炎的死亡率和发病率。关键词: 坏死性筋膜炎 坏死组织清创术 绿脓杆菌
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