Gecikilen vakada kaçınılmaz ölüm: Nekrotizan Fasiit olgu sunumu

Nekrotizan fasiit; travma sonrası gelişebilen, deri ve yumuşak dokuların enfeksiyonu ile karakterize, progresif ilerleyen kritik bir hastalıktır. Acil servise genel durum bozukluğu ve şuur değişikliği şikayetleri ile getirilen, 4 ay önce travma öyküsü olan ve nekrotizan fasiit tanısı alan bir olgu sunulmuştur. Nekrotizan fasiit tanısının koyulmasında bilgisayarlı tomografinin önemli bir yeri vardır. Tanı alan hastaların tedavisi; geniş spektrumlu antibiyoterapi ve erken cerrahi debridmandan oluşmaktadır.

INEVITABLE DEATH IN DELAYED CASE: NECROTIZING FASCIITIS CASE REPORT

Necrotizing fasciitis is a critical progressive disease characterized by the infection of the skin and soft tissue, which may develop after trauma. A case of trauma history and necrotizing fasciitis diagnosed 4 months ago was presented with complaints of general state of impairment and consciousness change. Computed tomography plays an important role in the diagnosis of necrotizing fasciitis. Treatment of diagnosed patients is with wide spectrum antibiotics and early surgical debridement.

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Khamnuan P, Chongruksut W, Jearwattanakanok K, Patumanond J, Tantraworasin A. Necrotizing fasciitis: epidemiology and clinical predictors for amputation. Int J Gen Med 2015;8:195‐202.
Carbonetti F, Cremona A, Carusi V, Guidi M, Iannicelli E, Di Girolamo M. The role of contrast enhanced computed tomography in the diagnosis of necrotizing fasciitis and comparison with the laboratory risk indicator for necrotizing fasciitis (LRINEC). Radiol Med 2016;121:106‐21.
Colak E, Ozlem N, Kucuk GO, Aktimur R, Kesmer S. Laboratory risk indicators for necrotizing fasciitis and associations with mortality. Turk J Emerg Med 2014;14:15‐9.
Turecki MB, Taljanovic MS, Stubbs AY et al. Imaging of musculoskeletal soft tissue infections. Skeletal Radiol 2010;39:957‐71.
Modlinska A, Osowicka M, Buss T, Lichodziejewska‐Niemierko M. The craniofacial necrotizing fasciitis after a minor trauma in an elderly white woman. J Clin Exp Dent 2014;6:307‐9.
Freiman A, Borsuk D, Sasseville D. Dermatologic emergencies. CMAJ 2005;173:1317‐19.
Fayad LM, Carrino JA, Fishman EK. Musculoskeletal Infection: Role of CT in the Emergency Department. Radiographics 2007;27:1723‐36.
Ocana Y, Ulloa‐Gutierrez R, Yock‐Corrales A. Fatal Necrotizing Fasciitis in a Child following a Blunt Chest Trauma. Case Rep Pediatr 2013;2013:373712.
McDonald LS, Shupe PG, Raiszadeh K, Singh A. Misdiagnosed pneumothorax interpreted as NF of the chest wall: case report of potentially prevntable death. Patient Saf Surg 2014;8:20.
Stevens DL, Bisno AL, Chambers HF et al. Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America. Clin Infect Dis 2014;59:10‐52.
Pecic V, Nestorovic M, Kovacevic P, Tasic D, Stanojevic G. Catastrophic necrotizing fasciitis after blunt abdominal trauma with delayed recognition of the coecal rupture ‐ case report. Ulus Travma Acil Cerr Derg 2014;20:143‐6.
Puvanendran R, Huey JC, Pasupathy S. Necrotizing fasciitis. Can Fam Physician 2009;55:981‐7.