抜歯後に発生した頸部ガス壊疽の2例

Two Cases of Gas Gangrene in the Neck after Extraction of Teeth

　はじめに

　ガス壊疽はガス産生性壊疽性感染症の総称であり，頭頸部での発生は比較的稀といわれていたが，近年，本邦における頭頸部領域でのガス壊疽症例の報告は稀ではなくなってきている^1〜4）。急速に炎症が進行するため，生命の予後を左右する重篤な感染症で，早期診断のうえで速やかな治療が非常に重要である。今回われわれは，糖尿病を基礎疾患にもち抜歯後に発症した頸部ガス壊疽の2症例を経験したので，若干の文献的考察を加えて報告する。

Gas gangrene in the neck is rare but life-threaten-ing infection that easily progresses to mediastinitis and damages vital organs in the chest.

A 43 year-old and a 46 year-old males wereboth referred to our hospital separately because of severe infection after an extraction of teeth. Neck and chest CT revealed gas collection with abscess formation in the neck, and mediastinitis due to neck infection was diagnosed in both cases. Admini-stration of antibiotics as well as gamma-globulin was followed by emergency surgical drainage. The latter case required additional hyperbaric oxygen therapy. Rapid diagnosis, rapid surgical drainage and appropriate chemotherapy were indispensable for salvaging patient's life.