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Craniocervical necrotizing fasciitis: an 11-year experience
S J Bahu1, T Y Shibuya, R J Meleca
1Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
Summary
Aggressive treatment of craniocervical necrotizing fasciitis (CCNF) involving broad-spectrum antibiotics and surgical interventions led to high survival rates. This approach proved effective even in cases with thoracic extension, demonstrating significant patient outcomes.
Area of Science:
- Infectious Diseases
- Surgical Critical Care
- Head and Neck Surgery
Background:
- Craniocervical necrotizing fasciitis (CCNF) is a severe soft tissue infection.
- CCNF requires prompt and aggressive management to prevent mortality.
- Thoracic extension of CCNF presents a significant challenge.
Purpose of the Study:
- To review institutional experience with craniocervical necrotizing fasciitis (CCNF).
- To present a successful treatment approach for CCNF.
- To analyze outcomes, particularly in cases with thoracic involvement.
Main Methods:
- Retrospective review of 10 CCNF cases from 1989-2000.
- Analysis of infection source, extent, microbiology, comorbidities, and treatment details.
- Evaluation of hospital days, ICU stay, surgical interventions, complications, and survival rates.
Main Results:
- Ten cases of CCNF were identified and analyzed.
- Fifty percent of cases (5/10) showed thoracic extension of the infection.
- Average treatment included 24 hospital days, 14 ICU days, and 3 surgical procedures per patient.
Conclusions:
- Aggressive wound care, broad-spectrum antibiotics, and multiple surgical interventions are crucial for CCNF management.
- The study achieved a 90% overall survival rate (9/10).
- An 80% survival rate (4/5) was observed in patients with thoracic CCNF extension.