Martwicze zapalenie tkanek twarzoczaszki (tzw. rak wodny)
Journal Title: Polski Przegląd Otorynolaryngologiczny - Year 2013, Vol 2, Issue 1
Abstract
Cancrum oris is a devastating opportunistic infection which destroys the tissues of the face. The risk factors are poverty, malnutrition, poor oral hygiene, diabetes, recent illness, alcohol abuse and smoking, low birth weight, Acquired Immune Deficiency Syndrome or other conditions with impaired immune system. Without appropriate treatment, the mortality rate from noma is 70–90% especially among children. It evolves from a necrotizing gingivostomatitis to widespread orofacial gangrene causing grotesque deformation. This is very rare but serious condition occurring mostly in Africa but single cases were reported worldwide. After healing the stadium of inflammation the patient require multiple reconstructive surgery. Microbiological etiology depends on area where patient got infected but mostly involves Fusobacterium necrophorum, Pseudomonas aeruginosa, Prevotella intermedia and Staphylococcus spp. The 32-year-old male was admitted to Internal Medicine Department in very bad condition, unconscious, feverish, in diabetic coma. After stabilization he was transferred to ENT Department in order to treat widespread inflammation of the face. In differential diagnostic procedure conditions such as cancer, Wegener syndrome, AIDS, actinomycosis and mycosis were excluded. Examination of culture showed growth of Pseudomonas aeruginosa, Escherichia coli and Proteus mirabilis. Despite of intensive treatment the inflammatory infiltration spreaded. The CT scans showed advanced inflammatory process in temporal region, cheek, eyelids, optic nerve, extraocular muscles and orbital cavity. The removal of the entire orbital contents was decided and proceeded together with ophthalmologists. After widespread surgical treatment of the orbital, sphenoidal, temporal, nasal, ethmoidal and maxillar region the inflammation was cured.
Authors and Affiliations
Jacek Kozakiewicz, Agata Gierlotka , Elwira Teodorowicz
Keywords
Related Articles
- EP ID EP51109
- DOI -
- Views 201
- Downloads 0
The level of genes expression: IL-1, TNFα, OPG and the presence of the measles virus in the stapes of the patients with otosclerosis
Honorowi Członkowie Polskiego TowarzystwaOtorynolaryngologów Chirurgów Głowy i Szyi
Szanowne Koleżanki i Koledzy,przedstawiamy sylwetki Członków Honorowych PTORL mia-nowanych w trakcie 46. Zjazdu PTORL w Bydgoszczyw dniach 3–6 września 2014
Wykorzystanie techniki biopsji węzła wartowniczego w laryngologii onkologicznej
Nowotwory głowy i szyi zajmują 6 miejsce pod względem zachorowalności na nowotwory złośliwe na świecie. Skuteczność leczenia tej heterogennej grupy chorób zależy od radykalności zabiegu chirurgicznego oraz obecności prze...
Second primary malignancies of the Head and Neck region: A case report
Billroth was the first who introduced the concept that a patient could develop cancer twice. The last two decades have seen a widespread increase of the problem of second primary tumors (SPT). This fact led us to concern...
Przecięcie nerwu przedsionkowego u pacjenta z chorob ą Meniere'a i całkowitą głuchotą po uprzednim leczeniu gentamycyną
Meniere's disease is a clinic al syndrome resulting from idiopathic or secondary endolymphatic hydrops. Clinic al presentation includes recurrent vertigo attacks, unilateral sensorineural hearing loss, feeling of pressur...