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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.
Objective:
We review our experience and present our approach to treating craniocervical necrotizing fasciitis (CCNF).
Study Design:
All cases of CCNF treated at Wayne State University/Detroit Receiving Hospital from January 1989 to April 2000 were reviewed. Patients were analyzed for source and extent of infection, microbiology, co-morbidities, antimicrobial therapy, hospital days, surgical interventions, complications, and outcomes.
Results:
A review of 250 charts identified 10 cases that met the study criteria. Five cases (50%) had spread of infection into the thorax, with only 1 (10%) fatality. An average of 24 hospital days (7 to 45), 14 ICU days (6 to 21), and 3 surgical procedures (1 to 6) per patient was required.
Conclusion:
Aggressive wound care, broad-spectrum antibiotics, and multiple surgical interventions resulted in a 90% (9/10) overall survival and 80% (4/5) survival for those with thoracic extension.
Significance:
This is the largest single institution report of CCNF with thoracic extension identified to date.
