Cervical necrotizing fasciitis due to bacterial tonsillitis

Area of Science:

• Infectious Diseases
• Surgical Pathology
• Head and Neck Surgery

Background:

• Necrotizing fasciitis (NF) is a severe soft tissue infection with high mortality.
• Head and neck involvement, particularly cervical NF, is uncommon.
• Tonsillitis is a potential, though rare, primary source for cervical NF.

Observation:

• Four cases of cervical necrotizing fasciitis originating from tonsillitis were analyzed.
• Patient comorbidities included diabetes mellitus and prior steroid use.
• One patient experienced fatal septic shock due to acute respiratory failure.

Findings:

• Successful outcomes were achieved in three patients through prompt diagnosis.
• Aggressive surgical debridement, broad-spectrum antibiotics, and supportive care were key interventions.
• Streptococcus sp. was consistently identified; mixed flora with anaerobes were common.

Implications:

• Tonsillitis and peritonsillar abscess should be considered in the differential diagnosis of cervical NF.
• Immediate, aggressive multidisciplinary treatment is essential for improving survival rates.
• Early detection and intervention significantly impact patient prognosis in cervical NF.