A rare case of peritonsillar abscess resulting in cervical necrotizing fasciitis

Flores, Carmen; Matthews, Marc R.; Caruso, Daniel M.; Foster, Kevin N; Stroschein, Mariel

doi:10.1016/j.xocr.2017.08.005

Cited by 6 publications

(10 citation statements)

References 14 publications

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“…3,12 Both minor and major trauma are precipitating causes of NF. 3 Odontogenic infection is a common source of cervicofacial NF 13 ; other sources include peritonsillar abscess, 14 otitis media, 15 and sialadenitis. 16 Early recognition of NF is often difficult on clinical examination.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing fasciitis of the scalp stemming from odontogenic infection

Lee

Votto

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et al. 2019

Baylor University Medical Center Proceedings

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Necrotizing fasciitis is a severe, rapidly progressive infectious process characterized by rapid spread and extensive tissue destruction. This condition stems from a variety of sources, may affect any area of the body, and requires rapid diagnosis and aggressive intervention. We present a rare case of odontogenic infection progressing to acute cervicofacial necrotizing fasciitis of the scalp and neck.

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Section: Discussionmentioning

confidence: 99%

Necrotizing fasciitis of the scalp stemming from odontogenic infection

Lee

Votto

Read-Fuller

et al. 2019

Baylor University Medical Center Proceedings

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“…NF affecting the head and neck region is rare 1 . NF has been documented in patients with dental infections, traumatic neck wounds and deep space neck infections 1 .…”

Section: Introductionmentioning

confidence: 99%

Necrotising fasciitis of the head and neck: A case series from the West of Scotland

Dolan

Paterson

Buchanan

2023

Clinical Otolaryngology

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Necrotising fasciitis (NF) is a life-threatening infection which can affect the skin, subcutaneous tissue, superficial and deep fascia with muscular extension. 1 Predisposing factors include chronic immunocompromised states, such as prolonged corticosteroid use, diabetes mellitus and intra-venous drug use. 1 NF affecting the head and neck region is rare. 1 NF has been documented in patients with dental infections, traumatic neck wounds and deep space neck infections. 1 Periocular NF is very rare, with a rate of 0.24 cases per million per annum. 2 Mortality rates of NF can exceed 50%, with periocular NF mortality ranging from 3% to 10%. 2,3 The pathophysiological mechanism behind NF includes the seeding and proliferation of a bacterial pathogen in the subcutaneous tissue, triggering the release of inflammatory mediators, including toxins and cytokines. 2 This inflammatory cascade results in microthrombi formation heralding ischaemic necrosis of tissue. Severe pain, erythema, bullae formation, and surgical emphysema with systemic sepsis are hallmark features, which should raise suspicion.Four types of NF have been described in the medical literature, with types 1 and 2 the most prevalent. 3 Type 1 NF is a polymicrobial infection usually consisting of mixed anaerobes, and can account for up to 80% of all NF cases. 3 Type 2 usually has a monomicrobial aetiology, with Group A beta-haemolytic Streptococcus (GAS) as the most prevalent pathogen. 3 Type 2 NF accounts for 20%-30% of cases, and can present as aggressive and rapidly progressing. GAS can induce a large inflammatory response with type 2 NF more likely to produce bacteraemia, with streptococcal shock syndrome. 4

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“…The most common sources of facial necrotizing fasciitis are odontogenic, sinugenic, peritonsillar or salivary gland infections. Other causes such as trauma, burns, surgery, insect bites and radiation therapy have also been described but are rare [4,9,[11][12][13][14]. In 2018, Gore [10] described only 164 patients in the literature with odontogenic necrotizing fasciitis.…”

Section: Introductionmentioning

confidence: 99%

Necrotizing fasciitis of the face: current concepts in cause, diagnosis and management

Ahmadzada

Rao

Ghazavi

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review Necrotizing fasciitis of the face is uncommon but potentially life threatening. With adequate multidisciplinary treatment, mortality and has significantly improved. This article highlights current concepts and supporting literature in the management of facial necrotizing fasciitis. Recent findings Management of necrotizing fasciitis involving the face requires a multisciplinary team approach, including early medical and surgical intervention. With early haemodynamic support, broad spectrum antibiotics and aggressive surgical debridement, mortality has reduced significantly. Soft-tissue reconstruction can be effectively utilized once the infection has been adequately treated. Although some adjunctive treatment such as vacuum assisted closure dressing has shown to be of benefit, other treatments such as hyperbaric oxygen remains controversial. Summary Necrotizing fasciitis is an aggressive soft tissue involving that rapidly spreads along fascial planes. Necrotizing fasciitis involving the face is rare owing to its rich blood supply but is also difficult to manage due to the complex regional anatomy. Common sources are odontogenic, sinugenic, peritonsillar or salivary gland infections and often polymicrobial. The principles of treatment include early and aggressive haemodynamic support, broad spectrum antibiotics and aggressive surgical debridement. Often times repeat debridements following close monitoring is required. Reconstructive options are viable only after the infection has been adequately treated. Although mortality has significantly improved, mediastinal involvement, multiple comorbidities and delayed treatment confers a worse prognosis.

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A rare case of peritonsillar abscess resulting in cervical necrotizing fasciitis

Cited by 6 publications

References 14 publications

Necrotizing fasciitis of the scalp stemming from odontogenic infection

Necrotizing fasciitis of the scalp stemming from odontogenic infection

Necrotising fasciitis of the head and neck: A case series from the West of Scotland

Necrotizing fasciitis of the face: current concepts in cause, diagnosis and management

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