合併白色念珠菌病之頸顏面壞死性筋膜炎－病例報告

Cervicofacial Necrotizing Fasciitis Combined with Candidiasis－A Case Report

柯文昌(Wen-Chang Ko) ； 歐嘉得(Chia-Teh Ou)

《中華民國口腔顎面外科學會雜誌》 13卷1期 (2002/03) Pp. 59-69

https://doi.org/10.7104/CJOMS.200203.0059

摘要

頸顏面部壞死性筋膜炎(Cervicofacial necrotizing fasciitis)是一種頭頸部快速進展性的高危險性疾病，具有很高的致死率。其致病菌通常包含有厭氧性及好氧性細菌，似具有協同性。近年來的研究發現貝它溶血性鏈球菌(Beta-hemolytic streptococcus)扮演著很重要的地位。然而黴菌感染對於此疾病所扮演之角色卻仍然不甚清楚，在文獻上之記載非常少。此疾病所可能引發之併發症包含有；縱膈炎(Pericarditis)，及縱膈膿瘍(Mediastitineal abscess)，心包膜炎(Pericarditis)，菌血症(Sepsis)，器官衰竭(Organ failure)等等。其致死率可達30%至60%。本篇報告提出一個頸顏面部壞死性筋膜炎合併白色念珠菌感染並產生多器官衰竭的病例，其致病源主要為白色念珠菌。疾病的發病及進程速度非常快，若無法及時提供外科手術清創以及加護照護的話，則可能造成很高的死亡率。另外就其合併症及預後情形加以討論。

關鍵字

頸顏面部壞死性筋膜炎 ； 白色念珠菌病

並列摘要

Cervicofacial necrotizing fasciitis (CNF) is a rapid-progressing infectious disease of head and neck with high mortality rate. The group A beta-hemolytic streptococci plays an important role in necrotizing soft tissue infection on recent studies of bacteriology. However, the pathogen of CNF are generally multiple and synergic, including both aerobic and anaerobic species. The role of fungus in this disease is still obscure. The complication of the disease included: mediastinitis or mediastinal abscess, pericarditis, sepsis, multiple organ failure and others. We presented a case of cervicofacial necrotizing facilitis with candidiasis and combined with multiple organ failure. In this paper, the pathogene was mainly candidus; the onset and progression of the disease were rapid. The treatment and the prognosis of the disease were also discussed.

並列關鍵字

cervicofacial necrotizing fasciitis ； candidiasis