Arda Şakir YILMAZ, Bartu BADAK, Ahmet Ümit CEBECİ

Şiddetli Nekrotizan Fasiit: Olgu Sunumu

Nekrotizan fasiit (NF), cilt altı doku ve fasyaları etkileyen, hızla yayılan inflamasyon, tromboz ve nekrozla seyreden, nadir görülen, ciddi bir bakteriyel yumuşak doku enfeksiyonudur. Dokularda hızla yayılan nekroz sıklıkla sistemik sepsise, toksik şok sendromuna ve çoklu organ yetmezliğine neden olur. Mortalite ve morbidite oranlarının oldukça yüksek olduğu bu klinik tabloda erken başvuru, erken tanı ve erken etkin tedavinin bu oranları dramatik bir şekilde azalttığı daha önce yapılan çalışmalar ve sunumlar ile net bir şekilde ortaya konmuştur. Tekrarlayıcı debridmanlar ve zorlu bir yara bakım sürecinin gerekli olabileceği bu tabloda etkili bir yoğun bakım takibinin gerekli olduğu aşikardır. Yeterli ve uygun nekroze dokuların debridmanı ve uygun antibiyoterapinin en etkili tedavi yöntemi olarak görüldüğü bu süreçte çeşitli yara bakım tedavileri de kullanılabilmektedir. Bu olgu sunumunda dış merkezden merkezimize akut renal yetmezlik ön tanısı ile refere edilen ve yapılan tetkikler sonrası şiddetli nekrotizan fasiit tablosunu, bu denli yaygın ve şiddetli tablonun ağırlığını, resimler ve laboratuvar bulguları eşliğinde literatüre katkı sağlamayı amaçladık.

Anahtar Kelimeler:

nekrotizan fasiit, yumuşak doku nekrozu, yumuşak doku enfeksiyonu

Severe Necrotizing Fasciitis: Case Report

Necrotizing fasciitis (NF) is a rare, serious bacterial soft tissue infection that affects the subcutaneous tissue and fascia and is characterized by rapidly spreading inflammation, thrombosis and necrosis. Rapidly spreading necrosis in tissues often causes systemic sepsis, toxic shock syndrome, and multiple organ failure. In this clinical picture where mortality and morbidity rates are quite high, it has been clearly demonstrated by previous studies and presentations that early admission, early diagnosis and early effective treatment reduce these rates dramatically. It is obvious that an effective intensive care follow-up is required in this situation where repetitive debridements and a difficult wound care process may be required. Various wound care treatments can also be used in this process, where debridement of adequate and appropriate necrosis tissues and appropriate antibiotic therapy are seen as the most effective treatment method. In this case report, we aimed to contribute to the literature with the severe necrotizing fasciitis picture, the severity of such a common and severe picture, accompanied by pictures and laboratory findings, which was referred to our center from another center with a preliminary diagnosis of acute renal failure and after the examinations performed. nary diagnosis of acute renal failure and after the examinations performed.

Keywords:

nekrotizing fasciitis, soft tissue necrosis, soft tissue infection,

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