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Mucormycosis: necrotizing soft tissue lesion of the face

2003; Elsevier BV; Volume: 61; Issue: 11 Linguagem: Inglês

10.1016/s0278-2391(03)00740-7

1531-5053

Christoph Leitner, Jürgen Hoffmann, M. Zerfowski, Siegmar Reinert,

Streptococcal Infections and Treatments

Spontaneous necrotizing soft tissue lesions of the face are seen rarely in a maxillofacial surgeon's daily practice. Depending on the type of tissue involved, they can be differentiated into necrotizing cellulitis, fasciitis, and myonecrosis. Necrotizing cellulitis affects the skin and is usually caused by monomicrobial infection. Group A Streptococcus, Staphylococcus, aerobic coliforms, and Clostridia are known to be the main causal agents. Necrotizing fasciitis affects primarily the subcutaneous tissues, with little initial effect on the skin but necrosis in advanced stages of the disease. It occurs as the result of polymicrobial synergistic aerobic and anerobic gas-producing infection with streptococci and, less often, the mucormycosis-causing agents Rhizopus, Mucor, or Absidia. Myonecrosis primarily affects the muscle and is caused by Clostridium perfringens, Streptococcus pyogenes, or group B Streptococcus. Clinical differentiation between these types can cause problems because they can appear to be very similar.