期刊
WORLD JOURNAL OF CLINICAL CASES
卷 10, 期 31, 页码 11630-11637出版社
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.12998/wjcc.v10.i31.11630
关键词
Craniofacial necrotizing fasciitis; Septic emboli; Klebsiella pneumoniae; Secondary; Case report
资金
- National Research Foundation of Korea - Korea Government (MSIT) [2021R1G1A1008337]
- Soonchunhyang University Research Fund
- National Research Foundation of Korea [2021R1G1A1008337] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
Craniofacial necrotizing fasciitis is a rare and fatal infection that can spread rapidly. Early management is crucial for optimal outcomes. This case report presents a patient with secondary CNF, whose symptoms improved after surgical treatment.
BACKGROUND Craniofacial necrotizing fasciitis (CNF) is an uncommon but fatal infection that can spread rapidly through the subfascial planes in the head and neck region. Symptoms usually progress rapidly, and early management is necessary to optimize outcomes. CASE SUMMARY A 43-year-old man visited our hospital with left hemifacial swelling involving the buccal and submandibular areas. The patient had fever for approximately 10 d before visiting the hospital, but did not report any other systemic symptoms. Computed tomography scan demonstrated an abscess with gas formation. After surgical drainage of the facial abscess, the patient's systemic condition worsened and progressed to septic shock. Further examination revealed pulmonary and renal abscesses. Renal percutaneous catheter drainage was performed at the renal abscess site, which caused improvement of symptoms. The patient showed no evidence of systemic complications during the 4-mo post-operative follow-up period. CONCLUSION As the patient did not improve with conventional CNF treatment and symptoms only resolved after controlling the infection, the final diagnosis was secondary CNF with septic emboli. Aggressive surgical decompression is important for CNF management. However, if symptoms worsen despite early diagnosis and management, such as pus drainage and surgical intervention, clinicians should consider the possibility of a secondary abscess from internal organs.
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