Cervical Necrotizing Fasciitis

Abstract

Cervical necrotizing fasciitis (CNF) is an aggressive infection of the head and neck with high complication and mortality rates. Sixty-eight cases of CNF have been reported in the English-language literature. We present a series of 8 patients with CNF, including 5 men and 3 women ranging in age from 25 to 92 years. To the best of our knowledge, this is one of the largest case series reported. Six of the 8 patients had a predisposing odontogenic focus of infection. Four patients had mediastinal involvement. Two patients, both with significant comorbidity at the time of presentation, died of CNF.

Cervical Necrotizing Fasciitis: Sources and Outcomes

“…Four of 12 patients who suffered from peritonsillar abscess died. The mortality rate was 33% in comparison with 25% for patients with a predominantly odontogenic cause of CNF [12]. Our recent experience of patients with CNF of odontogenic source supports the findings of Kantu et al [12].…”

“…Eight (67%) patients in table 1 had some complication in contrast to 62% in CNF of predominantly odontogenic origin [12].…”

“…Later it was shown that most cases could be attributed to Streptococcus spp. and Staphylococcus spp., although a mixture of facultative and anaerobic bacteria could also lead to this type of infection [12,13]. Several years ago some articles in the lay press warned of "flesheating bacteria" which caused several deaths in the United States [14], England [15] and Norway [4,16].…”

Cervical Necrotizing Fasciitis Due to Bacterial Tonsillitis

“…8 Predisposing factors include diabetes mellitus, steroid administration, arteriosclerosis, chronic renal failure, hypothyroidism, obesity, alcoholism, cancer, cirrhosis, drug abuse, and a poor nutritional state, all involved with loss of host defenses. 1,4 As it is a rare and unsuspected clinical condition, early diagnosis is not easy. We report on 4 cases of cervical necrotizing fasciitis arising from tonsillitis.…”

Severe neck infections that require wide external drainage: clinical analysis of 17 consecutive cases

“…Similar to the DNIs, cervical NFs can also lead to serious complications, and due to its more aggressive behaviour, NF shows even higher mortality rates [19,20]. Although DNI and NF are usually separately discussed, NF can be a complication of DNI [6,18,21].…”