Facial necrosing fasciitis in an immunocomprimed patient with hematological disease
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Abstract
Objective: To report the case of a patient with pernicious anemia and immunosuppression who presented with extensive necrotizing fasciitis in the face, of dental origin (periodontal disease), emphasizing the process of diagnosis and treatment with the resolution and follow-up of the case. Case details: Female patient, 57 years old, with pernicious anemia and immunosuppression, presented with a skin lesion in the buccinatory region on the right, whose initial diagnostic hypothesis was murcomycosis. Debridement of necrotic tissue was performed in the skin region of the cheek, bottom of the vestibule referring to tooth 13 and extraction of this tooth, combined with culture, antibiogram and incisional biopsy. After the extraction, debridement and therapeutic adequacy procedures, there was a noticeable improvement in the patient's condition. Final considerations: Facial necrotizing fasciitis is a rapidly progressive disease that can culminate in severe and fatal conditions and is intensified in the presence of risk factors. Appropriate treatment should include early diagnosis, broad-spectrum antibiotic therapy, which is based on culture and antibiogram tests, and surgical intervention, since removal of the cause can determine infection control, combined with topical treatment and management. concomitant systemic conditions.
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