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Necrotizing buccal and cervical fasciitis.
M Yamaoka1, K Furusawa, M Kiga
1Oral and Maxillofacial Surgery Dept. II, Matsumoto Dental College, Nagano, Japan.
Summary
A bite wound caused severe necrotizing fasciitis in deep neck spaces, indicating a Streptococcus and Bacteroides infection. Prompt surgical intervention and antibiotics led to successful patient recovery.
Area of Science:
- Infectious Diseases
- Surgical Pathology
- Head and Neck Surgery
Background:
- Necrotizing fasciitis is a rapidly progressive bacterial infection that can affect deep fascial planes.
- Deep neck space infections, particularly those involving the carotid sheath, pose significant risks due to proximity to vital structures.
Observation:
- A patient presented with a bite wound that rapidly progressed to necrotizing fasciitis.
- The infection involved critical anatomical regions: the temporal space, lateral pharyngeal space, and carotid sheath.
Findings:
- Microbiological analysis suggested a polymicrobial infection, with Streptococcus and Bacteroides species identified as likely causative agents.
- The necrotizing fasciitis was characterized by extensive tissue destruction within the involved deep neck spaces.
Implications:
- Aggressive surgical management, including repeated incisions and radical debridement, is crucial for controlling deep neck space necrotizing fasciitis.
- Appropriate antibiotic therapy targeting the identified pathogens is essential for successful treatment and patient outcomes.
- This case highlights the importance of early recognition and prompt, multidisciplinary intervention for severe bite-related deep neck infections.