歯性感染に続発した敗血症性肺塞栓症を伴った頭頸部ガス壊疽の1例

抄録

Gas gangrene is a progressive infectious disease that leads to muscle tissue necrosis. Here we report a patient with head and neck gas gangrene accompanied by septic pulmonary embolism (SPE). The patient was an 80-year-old female who showed swelling and crepitation accompanied by redness in the left temporal region, buccal region, submandibular region, and neck. Blood tests showed a WBC of 23,400/μL and CRP of 18.40 mg/dL. Computed tomography imaging revealed residual roots and periapical lesions at the left lower 4567 and left upper 56, and extensive soft tissue swelling and gas were noted in the left temporal region, masticatory space, submandibular region, and neck. Moreover, multiple nodules partially accompanied by a cavity were noted in the lung, however no abscess was clearly evident in the mediastinum. The patient was diagnosed with extensive head and neck gas gangrene accompanied by SPE, which developed secondary to the odontogenic infection. The patient was then immediately operated upon under general anesthesia to insert incisional drainage in the head and neck region. ABPC/SBT antibiotic was administered intravenously at 9 g/day for three weeks. The inflammation improved with time, and the patient was discharged on the 46^th hospital day.