{"created":"2022-05-26T06:33:57.721164+00:00","id":2000524,"links":{},"metadata":{"_buckets":{"deposit":"d9d62319-22b9-4f7f-81da-56f88d2e4ccc"},"_deposit":{"id":"2000524","owners":[1],"pid":{"revision_id":0,"type":"depid","value":"2000524"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:02000524","sets":["432:1291:1292:1653546419953","453:456"]},"author_link":[],"item_1627361970403":{"attribute_name":"出版タイプ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2014-12","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"112","bibliographicPageStart":"107","bibliographicVolumeNumber":"44","bibliographic_titles":[{"bibliographic_title":"新潟歯学会雑誌","bibliographic_titleLang":"ja"}]}]},"item_7_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"Necrotizing fasciitis is a severe infection with rapid necrosis of the fascia. Early diagnosis and surgical debridement are critical for reducing associated morbidity and mortality. However, the diagnosis of necrotizing fasciitis can be difficult in the initial stage because it is necessary to integrate several observations. We report here a case of cervical necrotizing fasciitis for which diagnosis and treatment were difficult. The patient was a 72-year-old female who had a complaint of swelling at the submandibular region and respiratory discomfort. She was referred to a certain hospital, where she took antibiotics and underwent incision and drainage vepeatedly. However, she was admitted to our hospital because of exacerbated inflammatory vesponse. We made a diagnosis of cervical phlegmon or a cervical necrotizing fasciitis. Therefore, we administered antibiotics and performed emergency surgery. We confirmed necrotic tissue in platysma and investing layer of deep cervical fascia. We therefore made a diagnosis of cervical necrotizing fasciitis. The patient recovered with surgical debridement and antibiotic medication. However, the risk of necrotizing fasciitis was high when the case was evaluated by LRINEC score. For that reason, we suggest that early scoring by LRINEC score is useful for an early diagnosis and early treatment of necrotizing fasciitis.","subitem_description_language":"en","subitem_description_type":"Abstract"},{"subitem_description":"頸部壊死性筋膜炎は筋膜や皮下組織の急激な壊死と急速な進行を特徴とする重症感染症で，適切な治療が行われない場合に致命的になる可能性があり，早期診断，早期治療が非常に重要であると言われている。しかし，その診断は多数の所見から総合的にされるため，早期診断に苦慮することがある。今回われわれは，診断および治療に苦慮した頸部壊死性筋膜炎の一例を経験したので報告する。患者は72歳女性。顎下部の腫脹，呼吸苦を訴え，某病院歯科口腔外科を受診し同日緊急入院した。抗菌薬投与，全身管理下に複数回にわたって口腔内外より切開排膿処置を行うも，さらなる炎症拡大を認めたため救急搬送で当科に入院した。当科初診時，右側顔面部から頸部に硬結を伴うびまん性の腫脹を認め，同部の皮膚は暗赤色を呈していた。右側頸部蜂窩織炎または右側頸部壊死性筋膜炎と診断し，抗菌薬の静脈内投与を開始し，局所麻酔下に頸部膿瘍を切開したところ広頸筋と深頸筋膜浅層組織に壊死を認めたため，壊死性筋膜炎と診断した。その後も積極的な外科的デブリードマンと適切な抗菌薬投与を行ったことにより致死的状況には至らなかったが，壊死性筋膜炎の補助的診断ツールとして近年有用性が示されているLRINEC scoreを自験例にあてはめると，某病院歯科口腔外科受診時は高リスク，当科初診時には中リスクであったことから，早期にスコアリングを行うことで早期診断と治療につながると考えられた。","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟歯学会","subitem_publisher_language":"ja"}]},"item_7_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00182415","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0385-0153","subitem_source_identifier_type":"PISSN"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"倉部, 華奈","creatorNameLang":"ja"},{"creatorName":"Kurabe, Kana","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"芳澤, 享子","creatorNameLang":"ja"},{"creatorName":"Yoshizawa, Michiko","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"小田, 陽平","creatorNameLang":"ja"},{"creatorName":"Oda, Yohei","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"金丸, 祥平","creatorNameLang":"ja"},{"creatorName":"Kanemaru, Shohei","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"船山, 昭典","creatorNameLang":"ja"},{"creatorName":"Funayama, Akinori","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"小林, 正治","creatorNameLang":"ja"},{"creatorName":"Kobayashi, Tadaharu","creatorNameLang":"en"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2022-05-26"}],"displaytype":"detail","filename":"44(2)_107-112.pdf","filesize":[{"value":"437KB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"objectType":"fulltext","url":"https://niigata-u.repo.nii.ac.jp/record/2000524/files/44(2)_107-112.pdf"},"version_id":"266027b4-3738-47b5-be57-5043fb3868ae"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"necrotizing fasciitis","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"LRINEC score","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"壊死性筋膜炎","subitem_subject_language":"ja","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"頸部壊死性筋膜炎の一例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"頸部壊死性筋膜炎の一例","subitem_title_language":"ja"},{"subitem_title":"A case of cervical necrotizing fasciitis","subitem_title_language":"en"}]},"item_type_id":"7","owner":"1","path":["456","1653546419953"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2022-05-26"},"publish_date":"2022-05-26","publish_status":"0","recid":"2000524","relation_version_is_last":true,"title":["頸部壊死性筋膜炎の一例"],"weko_creator_id":"1","weko_shared_id":-1},"updated":"2022-12-15T04:35:58.019470+00:00"}