ABSTRACT
A 28 year old male diabetic patient developed Ludwig's angina which subsequently evolved into cervicofacial necrotizing fasciitis. The differential characteristic of Ludwig's angina and cervicofacial necrotizing fasciitis, as it relates to this rare presentation is discussed. The clinical and radiological features, pathophysiology, diagnosis and the management that resulted in a successful outcome are presented
Subject(s)
Humans , Male , Fasciitis, Necrotizing/physiopathology , Ludwig's Angina/diagnosis , Ludwig's Angina/physiopathology , Fasciitis, Necrotizing/surgery , Diabetes MellitusABSTRACT
Necrotizing fasciitis is a rare soft tissue infection and a life-threatening emergency, often fatal. Its incidence and management are described plentifully in the medical literature regarding the most common anatomical sites involved like the abdomen, lower and upper limbs, and perineum. However, available data and case reports of chest wall necrotizing fasciitis after thoracic procedures are scarce, mainly after major cardiac operations. We report and discuss a case of necrotizing fasciitis of the chest wall occurring in the immediate postoperative period of a cardiac procedure, and include a brief review of the concepts, pathophysiology, and treatment reported in the medical literature. We emphasize the need for early diagnosis and urgent and effective surgical debridement. Of importance is the fact that we have not found any references in the literature to cases similar or equal to the one we describe here, which occurred in the postoperative period of a cardiac procedure
Subject(s)
Humans , Male , Adult , Cardiac Surgical Procedures/adverse effects , Fasciitis, Necrotizing/surgery , Postoperative Complications/surgery , Soft Tissue Infections/surgery , Thorax/microbiology , Debridement/methods , Drainage/methods , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/physiopathology , Postoperative Complications/diagnosis , Postoperative Complications/physiopathology , Soft Tissue Infections/diagnosis , Soft Tissue Infections/physiopathologyABSTRACT
Dentro de las infecciones necrotizantes de tejidos blandos, la fascitis necrotizante sigue siendo un desafío para los cirujanos por lo cual se realizó la siguiente revisión bibliográfica en la que se detalla la etiología, fisiopatología, histopatología, cuadro clínico, exámenes de laboratorio, diagnóstico diferencial y tratamiento temprano, que permitirán diagnosticar oportunamente y manejar de mejor manera ésta patología.
Subject(s)
Humans , Fasciitis, Necrotizing/etiology , Fasciitis, Necrotizing/physiopathology , Fasciitis, Necrotizing/therapyABSTRACT
A fasciíte necrotizante é uma infecçäo dos tecidos moles, causada geralmente por bactérias virulentas produtoras de toxinas. Caracteriza-se por necrose ampla do tecido celular subcutâneo e fáscias, com relativa preservaçäo da pele e músculos adjacentes. Está freqüentemente associada com toxemia sistêmica grave, sendo geralmente fatal se näo reconhecida prontamente e tratada de modo agressivo. As medidas terapêuticas específicas incluem o desbridamento cirúrgico, antibioticoterapia e medidas de suporte, como administraçäo de líquidos intravenosos e monitorizaçäo hemodinâmica.
Subject(s)
Humans , Fasciitis, Necrotizing/therapy , Gangrene , Hyperbaric Oxygenation , Debridement , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/epidemiology , Fasciitis, Necrotizing/physiopathology , Gangrene/diagnosis , Gangrene/mortality , Gangrene/physiopathology , PrognosisABSTRACT
Os autores apresentam estudo retrospectivo de 12 pacientes com fasciite necrosante da genitália masculina (Síndrome de Fournier), tratados no período de outubro de 1982 a maio de 1997. A idade variou de quatro a 72 anos, com média de 48,8 anos. O tratamento consistiu em cistostomia em cinco casos, antibioticoterapia sistêmica de largo espectro, desbridamentos agressivos e técnicas de reconstruçäo por cirurgia plástica (retalhos e enxertos cutâneos). Näo houve óbitos na série estudada e näo foram observadas seqüelas relevantes. Os autores concluem que o tratamento utilizado foi eficaz na abordagem da doença