Cervicofacial Necrotizing Fasciitis and Candida spp| Stephy Publishers
SOJ Dental and Oral Disorder - (SOJDOD) | Stephy Publishers
Abstract
Cervicofacial necrotizing fasciitis is a rapidly evolving
bacterial infection, which can be associated with multiple complications and
poor health. However, there are few reported cases that are associated with
Candida species, and the studies that report this indicate that it is found
mainly in areas such as the pelvis, thorax and to a lesser degree in the arms
and legs. The presence of Necrotizing Fasciitis in the cervicofacial region is
very rare, which makes the present study relevant.
Material and Method: Descriptive, observational and retrospective study of
Odontogenic Cervicofacial Necrotizing Fasciitis and the presence of Candida
spp., Carried out during one year, in the Maxillofacial Surgery service of the
Specialty Hospital, of the National Medical Center "La Raza" (IMSS).
Patients older than 18 years, who were diagnosed with Necrotizing Cervicofacial
Fasciitis of dental origin, were included in the study, reporting the presence
of Candida. Treatment consisted of debridement of necrotic tissue, culture,
dressings, intravenous antibiotics, and secondary surgical scrubs.
Results: In
one year, 7 cases of Cervicofacial Necrotizing Fasciitis of dental origin were
obtained, of which 3 patients had associated Candida species, the rest of the
cultures were reported polymicrobial. The most associated comorbidities were
uncontrolled diabetes mellitus and arterial hypertension, there was a
predilection for the male sex, the median age was 63 years, the ranges (min: 24
and max: 83). In addition, it was found that the 3 patients who presented
candida species in their cultures were overweight and their evolution was
torpid.
Conclusion: It
is important to perform cultures and biopsies to report the microbial species
found in pathologies such as Necrotizing Fasciitis and to be able to provide
better treatment specifically to the patient. Candida species do not usually
appear associated with Necrotizing Fasciitis, which is why when other
non-bacterial species are present, patients must undergo specific and
individualized treatment to treat bacterial infections (necrotizing fasciitis)
and in this case also the fungal (candida), remembering that the two act
synergistically.
Keywords
Fasciitis, Necrotizing, Candida, Odontogenic, Infection,
Cervicofacial
Abbreviations
SAH: Systemic Arterial Hypertension; MD: Mellitus Diabetes;
RD: Respiratory Diseases (chronic obstretric pulmonary disease and pneumonia);
CKD: Chronic Kidney Disease
Introduction
Necrotizing fasciitis
is an infection with a significant morbidity and mortality rate reported in the
literature (ranging from 9% to 69%),1–4 the pathogenesis
has not been fully specified, however it is known to be a multi bacterial
infection in which you can present synergy with other opportunistic
infections.1 The rapid spread of microorganisms through the facial planes leads
to necrosis of the fascia and the overlying subcutaneous tissue.5 If the process continues, it spreads vertically towards
the muscle.6 One of the main etiological factors
mentioned in the literature is immune suppression, major or minor penetrating
trauma, infections or cutaneous wounds with delayed healing, including open
surgical wounds with a high risk of infection.7,8 The main pathogens associated with necrotizing fasciitis
are bacterial, (necrotizing fasciitis can be divided by the type of bacterial
biota that is present). Four types are reported in the literature,9–11 some authors only divide it into two large groups
(polybacterial and monomicrobial).7,8 The complete
classification is presented below in Table 1.
To read more #Dental #OralDisorder
https://www.stephypublishers.com/sojdod/fulltext/SOJDOD.MS.ID.000508.php
#Openaccessjournals
https://www.stephypublishers.com/
Abstract
Cervicofacial necrotizing fasciitis is a rapidly evolving
bacterial infection, which can be associated with multiple complications and
poor health. However, there are few reported cases that are associated with
Candida species, and the studies that report this indicate that it is found
mainly in areas such as the pelvis, thorax and to a lesser degree in the arms
and legs. The presence of Necrotizing Fasciitis in the cervicofacial region is
very rare, which makes the present study relevant.
Material and Method: Descriptive, observational and retrospective study of
Odontogenic Cervicofacial Necrotizing Fasciitis and the presence of Candida
spp., Carried out during one year, in the Maxillofacial Surgery service of the
Specialty Hospital, of the National Medical Center "La Raza" (IMSS).
Patients older than 18 years, who were diagnosed with Necrotizing Cervicofacial
Fasciitis of dental origin, were included in the study, reporting the presence
of Candida. Treatment consisted of debridement of necrotic tissue, culture,
dressings, intravenous antibiotics, and secondary surgical scrubs.
Results: In
one year, 7 cases of Cervicofacial Necrotizing Fasciitis of dental origin were
obtained, of which 3 patients had associated Candida species, the rest of the
cultures were reported polymicrobial. The most associated comorbidities were
uncontrolled diabetes mellitus and arterial hypertension, there was a
predilection for the male sex, the median age was 63 years, the ranges (min: 24
and max: 83). In addition, it was found that the 3 patients who presented
candida species in their cultures were overweight and their evolution was
torpid.
Conclusion: It
is important to perform cultures and biopsies to report the microbial species
found in pathologies such as Necrotizing Fasciitis and to be able to provide
better treatment specifically to the patient. Candida species do not usually
appear associated with Necrotizing Fasciitis, which is why when other
non-bacterial species are present, patients must undergo specific and
individualized treatment to treat bacterial infections (necrotizing fasciitis)
and in this case also the fungal (candida), remembering that the two act
synergistically.
Keywords
Fasciitis, Necrotizing, Candida, Odontogenic, Infection,
Cervicofacial
Abbreviations
SAH: Systemic Arterial Hypertension; MD: Mellitus Diabetes;
RD: Respiratory Diseases (chronic obstretric pulmonary disease and pneumonia);
CKD: Chronic Kidney Disease
Introduction
Necrotizing fasciitis
is an infection with a significant morbidity and mortality rate reported in the
literature (ranging from 9% to 69%),1–4 the pathogenesis
has not been fully specified, however it is known to be a multi bacterial
infection in which you can present synergy with other opportunistic
infections.1 The rapid spread of microorganisms through the facial planes leads
to necrosis of the fascia and the overlying subcutaneous tissue.5 If the process continues, it spreads vertically towards
the muscle.6 One of the main etiological factors
mentioned in the literature is immune suppression, major or minor penetrating
trauma, infections or cutaneous wounds with delayed healing, including open
surgical wounds with a high risk of infection.7,8 The main pathogens associated with necrotizing fasciitis
are bacterial, (necrotizing fasciitis can be divided by the type of bacterial
biota that is present). Four types are reported in the literature,9–11 some authors only divide it into two large groups
(polybacterial and monomicrobial).7,8 The complete
classification is presented below in Table 1.
To read more #Dental #OralDisorder
https://www.stephypublishers.com/sojdod/fulltext/SOJDOD.MS.ID.000508.php
#Openaccessjournals
https://www.stephypublishers.com/
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