- 社団法人 日本口腔外科学会
- 日本口腔外科学会雑誌 (ISSN:00215163)
- vol.48, no.8, pp.423-426, 2002-08-20 (Released:2011-04-22)
A case of non-clostridial gas gangrene with sepsis in the maxillofacial region and neck caused byodontogenic infection is reported.A 74-year-old woman consulted our department because of painful swellingof the head and neck region.She had been treated for depression for about 20 years.Her general conditionwas classified as I-2 coma according to the Japan coma scale.Blood examination revealedleukocytosis, hepatopathy, nephropathy, hypoalbuminemia, and hyperglycemia.A computed tomographicscan showed gas accumulation with abscess formation in the temporal, buccal, submandibular, and cervicalregions.Administration of antibiotics (PAPM/BP) and gamma-globulin was followed by emergencysurgical drainage under general anesthesia. Microbiological examinations revealed Streptococcus pneumoniae in the abscess and Peptococcus asaccharolyticus in venous blood on the 1st disease day. Aftertreatment, the swelling disappeared and the results of blood tests became normal.However, a secondmicrobiological examination of venous blood also revealed Peptococcus asaccharolyticus on the 9 th diseaseday. Antibiotics (CLDM) were given from the 17th to 20th disease days.Hyperglycemia was controlledby insulin.She was discharged on the 53rd disease day.Rapid diagnosis by computed tomography, rapid surgical drainage, appropriate chemotherapy, and examinationsof blood cultures and for DIC are required to save patients'lives.