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Necrotizing fasciitis and mediastinitis.

S K Lazow1

  • 1Oral and Maxillofacial Surgery Residency Training Program, Kings County Hospital Center, Brooklyn, New York, USA.

Atlas of the Oral and Maxillofacial Surgery Clinics of North America
|February 24, 2001
PubMed
Summary

Necrotizing fasciitis and mediastinitis are severe orofacial infection complications. This study reviews their presentation, diagnosis, microbiology, surgical treatment, and hyperbaric oxygen therapy.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Orofacial infections can lead to rare but life-threatening complications.
  • Necrotizing fasciitis and mediastinitis represent severe sequelae requiring prompt recognition and management.

Purpose of the Study:

  • To comprehensively review necrotizing fasciitis and mediastinitis secondary to orofacial infections.
  • To discuss key aspects including clinical presentation, diagnostics, and treatment strategies.

Main Methods:

  • Literature review focusing on clinical presentation, diagnostic tools, and anatomical spread.
  • Analysis of microbiologic findings and surgical interventions.
  • Evaluation of adjuvant hyperbaric oxygen (HBO) therapy's role.

Main Results:

  • These conditions share overlapping clinical features but differ in anatomical involvement.
  • Polymicrobial infections are common, necessitating broad-spectrum antibiotics.
  • Aggressive surgical debridement and source control are paramount.

Conclusions:

  • Early diagnosis and multidisciplinary management are crucial for improving outcomes.
  • Adjuvant hyperbaric oxygen therapy may benefit selected patients.
  • Understanding pathways and microbiology aids in effective treatment of these grave infections.

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