覚醒剤濫用歴を有する顎顔面部蜂窩織炎の１例

Abstract

Stimulant abuse is a social problem in recent years. We describe a patient with a history of stimulant abuse who had flashback phenomena during hospitalization for the treatment of a maxillofacial phlegmon caused by intraoral self mutilation.The patient was a man in his forties who continued to take stimulants and served a sentence in prison since 1 year before admission to our hospital.He had pain in the left cheek for 1 month before admission to our hospital and was referred to a certain hospital. He was given a diagnosis of maxillofacial phlegmon with intracranial abscess on computed tomography. The patient was referred to the Department of Emergency and Critical Care Medicine in our hospital for further examination and treatments.Because the maxillofacial phlegmon was apparently caused by intraoral infection, he was referred to our department. With the patient under general anaesthesia, we performed drainage of the left fossa infratemporalis, intraorbital region, fossa pterygopalatine, and the submandibular space on the day of admission to our hospital. Incomprehensible speech and self mutilation occurred after the drainage. Amphetamine psychosis with flashback phenomenon was diagnosed by a psychiatrist in our hospital. Antipsychotic drugs and a tranquilizer were prescribed, and his symptoms improved.His prognosis was good. He returned to his original hospital 20 days after surgery.In conclusion, it is very important to recognize the clinical condition of amphetamine psychosis. The treatment of such patients requires close cooperation with a psychiatrist.