顔面に発生したガス壊疽の1例

抄録

Gas producing infections are considered to be rare in occurrence in the head and neck. A case of non-clostridial infection of which cause was unclear is reported.
A 84-year-old woman was refered to our clinic with a chief complaint of swelling in the face. She had marked swelling of he right face and neck regions. The radiological finding of the face showed abundant gas in the soft tissue.
The cultured face abscess revealed a growth of Bacteroide splanchnicus.
Clinical diagnosis was phlegmon. A surgical excision about 5×4 cm in size was made in the necrosis tissue of the buccal, and an incision and curettage were performed in gas producing abscess of the right face, neck and chest. After operation, the data of laboratory examinations (4.8×10⁴/m of platelet, 45% of prothrombin time) suggested disseminated intravascular coagulation (DIC). Gabexate (FOY^®) and Heparin were immediatly administered, and the hematological examinations required 3 weeks to improve.
In spie of irrigation, antibiotics (CTT, CLDM, CZX, PLB, CTM) and our intensive care which succeed to control the gas producing infection, the patient died of suffocation on 46 days after admission.