Cervicofacial necrotizing fasciitis: Report of three cases and literature review

Balcerak, R.J.; Sisto, John M.; Bosack, Robert C.

doi:10.1016/0278-2391(88)90410-7

Cited by 90 publications

(108 citation statements)

References 28 publications

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“…Otra consideración importante es la identificación de alguna complicación como lo puede ser la infección rápidamente progresiva conocida como fascitis necrotizante, la cual es ocasionalmente encontrada en cabeza y cuello, frecuentemente debido a una Io o en heridas postquirúrgicas 49 . la Fascitis necrotizante es una infección de rápida evolución que afecta al tejido celular subcutáneo, fascia, músculo platisma y puede descender hasta la pared toráxica.…”

Section: Evaluar Al Paciente Periódicamenteunclassified

“…la Fascitis necrotizante es una infección de rápida evolución que afecta al tejido celular subcutáneo, fascia, músculo platisma y puede descender hasta la pared toráxica. la DM y el alcoholismo son considerados factores de riesgo 49 . La sospecha de una fascitis necrotizante es una emergencia quirúrgica que requiere la administración de un antibiótico de amplio espectro, debridaje quirúrgico repetido, eliminación del tejido necrótico y un soporte médico intensivo.…”

Section: Evaluar Al Paciente Periódicamenteunclassified

“…La sospecha de una fascitis necrotizante es una emergencia quirúrgica que requiere la administración de un antibiótico de amplio espectro, debridaje quirúrgico repetido, eliminación del tejido necrótico y un soporte médico intensivo. la mortalidad global de la fascitis necrotizante oscila entre el 20 y el 47% 49 .…”

Section: Evaluar Al Paciente Periódicamenteunclassified

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Principios para el tratamiento de infecciones odontogénicas con distintos niveles de complejidad

2012

Rev Chil Cir

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Principles for the treatment of odontogenic infections with different levels of complexity odontogenic infections are one of the main causes of consultation in dental practice. these, affect individuals of all ages and are responsible for the majority of antibiotic prescriptions in the field of dentistry. odontogenic infections are generally underestimated in terms of morbidity and mortality, although the incidence and severity have decreased dramatically over the past 70 years. However, odontogenic infections can have varying degrees of severity and even some can be quite complex and need emergency care in a hospital setting under a specialist in oral and Maxillofacial surgery. odontogenic infections are commonly the result of pericoronitis, caries with pulp exposure, periodontitis or complication of a dental procedure. the literature contains various principles and approaches for odontogenic infections therefore the objective of our review is to establish a simplified manner based on the current literature, the principles that the clinician should follow to face odontogenic infections with different levels of complexity.Key words: odontogenic infection, odontogenic abscess, antibiotics.Resumen las infecciones odontogénicas son una de las principales causas de consulta en la práctica odontológi-ca. estas afectan a individuos de todas las edades y son responsables de la mayoría de las prescripciones de antibióticos en el campo de la odontología. las infecciones odontogénicas son generalmente subestimadas en términos de morbilidad y mortalidad, aunque su incidencia y severidad han bajado drásticamente en los últi-mos 70 años. sin embargo, estas infecciones pueden presentar distintos grados de severidad e incluso algunas pueden ser bastante complejas y necesitar una atención de emergencia en un ambiente hospitalario bajo un especialista en cirugía Bucal y Maxilofacial. las infecciones odontogénicas son comúnmente el resultado de una pericoronaritis, caries con exposición pulpar, periodontitis o la complicación de un procedimiento dental. . estas Ios pueden presentar distintos grados de severidad e incluso algunas pueden ser bastante complejas y necesitar atención de emergencia en un ambiente hospitalario bajo un especialista en cirugía Bucal y Maxilofacial.las Ios son generalmente subestimadas en térmi-nos de morbilidad y mortalidad, si bien la incidencia y severidad han bajado drásticamente en los últimos 70 años. Históricamente, la posibilidad de que un absceso de origen dental se propagara generando sepsis y la muerte ha sido conocido desde la antigüe-dad, aunque el rol de las bacterias en este proceso no fue descubierto hasta el siglo XX. cuando los certificados de defunción (Londres, Inglaterra) comenzaron a mostrar las causas de muerte a comienzos del 1600´s, las infecciones de origen dental ocupaban el sexto lugar 2 . en 1940, ahsbel Williams publicó una serie de 31 casos de angina de ludwig, la gran mayoría de origen dental, donde el 54% de los pacientes fallecieron 3 . tres años más tarde guralnic...

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Section: Evaluar Al Paciente Periódicamenteunclassified

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Principios para el tratamiento de infecciones odontogénicas con distintos niveles de complejidad

2012

Rev Chil Cir

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“…Various names have been ascribed to this lesion including hospital gangrene, gangrenous or necrotizing erysipelas, hemolytic or acute streptococcal gangrene, suppurative fasciitis, Meleney's gangrene and Fournier's gangrene. The term necrotizing fasciitis was first coined by Wilson in 1952 [1][2][3][4].…”

Section: Discussionmentioning

confidence: 99%

“…As the disease progresses, the skin becomes dusky and small blisters appear. The skin necrosis is secondary to thrombosis of the nutrient vessels passing through fascia [1,6,7]. The patient is acutely ill, with low to medium grade fever associated with tachycardia out of proportion to the temperature elevation [3].…”

Section: Discussionmentioning

confidence: 99%

Necrotizing Fasciitis: An Unusual Presentation

Sasindran

Joseph

2011

Indian J Otolaryngol Head Neck Surg

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Necrotizing fasciitis (NF) is rare but life threatening multimicrobial soft tissue infection characterized by progressive, usually rapid, necrotizing process of the subcutaneous tissues and fascial planes, with resulting skin gangrene and systemic toxicity. The groin, abdomen and extremities are the most frequent sites involved by this disease and it is rarely seen in the head and neck region. NF of the head and neck region has a potentially high morbidity and mortality. Delay in diagnosis leads to poor outcome. Hence early recognition and aggressive management is imperative for successful outcome. Here we present a case of acute onset of cervical necrotizing fasciitis in a young male.Keyword Necrotizing fasciitis Á Soft tissue infections Á Diabetes mellitus Case ReportA 33-year old male presented to the emergency room complaining of painful neck swelling with difficulty in breathing. Patient was apparently alright the previous night and noticed the swelling during the early morning hours. The cervical swelling increased over the next few hours and was brought to the hospital by noon. Patient did not have any associated history of throat pain, trauma, or tooth ache. He was a normotensive and not a diabetic, had family history of diabetes. Examination showed a diffuse swelling of submental and submandibular region with edema of the floor of the mouth with trismus. The skin over the swelling was erythematous, tender and the swelling was fluctuant. Provisionally a diagnosis of Ludwig's angina with submandibular abscess was made. Patient had difficulty in breathing on lying down. A X-ray neck lateral view done else where showed evidence of airway obstruction (Fig. 1). Patient was shifted for CT scan and developed stridor on table. Hence he was immediately rushed to the theatre and an emergency tracheostomy was done. A low tracheostomy was done as none of the landmarks in the neck could be identified (Fig. 2).It was decided to explore the neck on table. A transverse incision was made over the submental region. The whole subcutaneous fat and partly the muscles were found to be necrosed (Fig. 3) and it was foul smelling. A brownish fluid oozed out of the muscle planes and there was no evidence of pus in the submental or submandibular space. Deep cervical fascia was found to be necrosed and the debrided tissues were sent for histopathological examination. Similarly the parapharyngeal spaces were explored on either sides through a separate vertical incision along the sternocleiodomastoid to look for any abscess formation. Necrosed subcutaneous fat from these areas were debrided and a swab was sent for culture sensitivity from these necrosed areas. A dental examination was also done in the same sitting to look for any dental foci. However the oral cavity and oropharynx were normal except for edematous floor of the mouth. The explored areas were left open and antibiotic dressings applied. Blood report showed leukocytosis. His random sugar levels were 350 mg/dl. Glycosylated haemoglobin was 9.5. Patient was started...

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