Three Cases of Necrotizing Fasciitis.

概要

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We have experienced three cases of necrotizing fasciitis. Of these three cases, two cases were associated with perineal abscess and intravenous drug injection. They had no premorbid medical problems such as diabetes mellitus, peripheral vascular disease, carcinoma and intravenous drug abuse. The remaining case had severe diabetes mellitus as underlying disease, and the infection occurred in her left thigh which was preceded by antecedent urinary infection. The etiology between both infections was still obscure. All three cases fell into shock state including hypotension, but were successfully treated with fluid rescucitation, antibiotics, surgical debridement and hyperbaric oxygen therapy (HBO). All of them had good prognosis. Most determinant factor correlating with the prognosis is the early diagnosis and surgical intervention. Early diagnosis of this disease is often diificult and relies on a high clinical suspicion. HBO therapy, if available, shoud be considered after the surgical treatment.
日本臨床外科学会の論文