痔瘻から発生したガス産生壊疽性筋膜炎の1例

概要

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A case of necrotizing fasciitis developed from an anorectal fistula was reported.<BR>A 53-year-old man was admitted to our hospital complaining of scrotal swelling and abdominal pain. An abdominal X-ray examination revealed a subcutaneous abnormmal gas formation in the scrotum and inguinal region. Body CT examination also revealed abnormal gas formation in the abdomen from the level of the pancreas to the sacrum. Immediately, drainage with extensive debridement of necrotic tissue and colostomy were performed combined with chemotherapy using broad spectrum antibiotcs. Cultures of the pus were positive for Bacteroides fragilis, Pseudomonas aeruginosa, E. coli, and Enterobacter cloacae.<BR>Necrotizing fasciitis developed from anal disease is a relatively uncommon disease and known for its high mortality rate. In Japan, only 29 cases have been reported and 15 cases with diabetes mellitus. It was thought to be important that we should pay attention to the prevention of a serious systemic infection such as necrotizing fasciitis. when the patient of anorectal disease had a past history of diabetes mellitus.