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Cervical necrotizing fasciitis

R H Maisel1, R Karlen

  • 1University of Minnesota, Department of Otolaryngology-Head and Neck Surgery, Minneapolis 55415-1829.

The Laryngoscope
|July 1, 1994
PubMed
Summary
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Necrotizing fasciitis of the neck, a severe soft-tissue infection, requires prompt surgical exploration and broad-spectrum antibiotics. Early airway management and intensive support, including hyperbaric oxygen for severe cases, are crucial for successful patient outcomes.

Area of Science:

  • Infectious Diseases
  • Head and Neck Surgery
  • Bacteriology

Background:

  • Necrotizing fasciitis is a rapidly progressive bacterial infection affecting the deep fascia and subcutaneous tissues.
  • Cervical necrotizing fasciitis presents a significant threat to airway patency and can lead to severe morbidity and mortality.
  • Understanding the diverse origins and polymicrobial nature of this infection is critical for effective management.

Purpose of the Study:

  • To present a series of cervical necrotizing fasciitis cases.
  • To analyze the origins, bacteriology, and treatment outcomes.
  • To recommend optimal management strategies for this life-threatening condition.

Main Methods:

  • Retrospective review of nine cases of cervical necrotizing fasciitis.

Related Experiment Videos

  • Analysis of patient demographics, infection sources (odontogenic, pharyngeal, spider bite), and causative microorganisms.
  • Evaluation of treatment protocols including antibiotics, surgical intervention, and adjunctive therapies.

    • Main Results:

    • The nine cases included five odontogenic, three pharyngeal, and one spider bite origin.
    • Bacteriological analysis revealed a polymicrobial infection involving gram-positive, gram-negative, and anaerobic bacteria.
    • Initial treatment with third-generation cephalosporins and metronidazole or clindamycin showed successful outcomes.

    Conclusions:

    • Early airway control and wide surgical exploration of neck fascial spaces are paramount.
    • Frequent reexploration is necessary to monitor treatment efficacy and disease progression.
    • Intensive medical support, including hyperbaric oxygen for deteriorating patients, is advised.