扁桃周囲炎に続発した頸胸部ガス壊疽の1症例

A Case of Serius Gas Producing Phlegmon in the Neck and the Chest Following Peritonsillitis

I．はじめに

　ガス壊疽とはガス産生を伴う壊疽性の軟部組織感染症で，しばしば致死的な疾患である。外傷などを契機に四肢に発症することが多く，頭頸部領域に発生することは稀で，発症率は年間0.1人/10万人以下^1）である。

　今回，扁桃周囲炎に続発した頸胸部非クロストリジウム性ガス壊疽の症例を経験し，治療に難渋したため若干の文献的考察を加えて報告する。

　A 61-year-old woman developed a serious gas producing phlegmon extending from the left neck to the right chest.

　Clinical examinations revealed left peritonsillitis,deep neck infection. Antibiotic treatment was initiated intravenously. In spite of the improvement of lab data,local conditions became deteriorated and CT showed gas formation.

　Incision and drainage was performed but inflammation was not controlled.

　Excision of the skin and extensive surgical debridment in the left neck and the right chest improved the patient's conditions.

　Immediate and extensive surgical debridment is considered the most important treatment for gas producing phlegmon.