Arch Craniofac Surg.  2018 Sep;19(3):222-226. 10.7181/acfs.2018.01928.

Staged lower lip reconstruction following gangrenous stomatitis in an immunosuppressed patient

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Myongji Hospital, Goyang, Korea. jyyang2@mjh.or.kr

Abstract

A 70-year-old male with a history of diabetes mellitus, hypertension, and coronary stent insertion visited our hospital 7 days after biting his lower lip. Swelling and inflammation had worsened despite debridement and antibiotic treatment. On the 8th hospital day, fungal infection with Candida albicans and superimposed bacterial infection with Klebsiella pneumoniae were found on tissue culture. Extensive necrosis resulted in a defect of approximately 3/4 of the entire lower lip and a full-layer skin defect from the vermilion to the gingivobuccal sulcus at the right corner of the mouth. To correct drooling, incomplete lip sealing, and trismus, staged reconstruction was performed with consideration of cosmetic and functional features. The treatment process using staged reconstruction and antifungal treatment for an extensive lower lip defect caused by fungal stomatitis is described.

Keyword

Stomatitis; Candida; Gangrene

MeSH Terms

Aged
Bacterial Infections
Candida
Candida albicans
Debridement
Diabetes Mellitus
Gangrene
Humans
Hypertension
Inflammation
Klebsiella pneumoniae
Lip*
Male
Mouth
Necrosis
Noma*
Sialorrhea
Skin
Stents
Stomatitis
Trismus
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