Necrotizing Fasciitis of the Face and Neck

Abstract

Necrotizing fasciitis is a rare infection in the surgical and infectious medical services, but when it is present, in most cases, the affected areas are the lower extremities and the abdominal and thoracic walls, and more frequently in perineum and genital areas, which is commonly known as Fournier's gangrene. This type of infection is extremely rare in the face and neck, because the great vascularity in these regions makes the tissues rarely susceptible to ischemia and infection, even when large flaps are lifted in reconstructive and aesthetic procedures. We present a case of necrotizing fasciitis in face and neck, with emphasis on the medical and surgical treatment that should be based on antibiotic therapy of broad spectrum; secondary reconstructive procedures should be planned.

Cervical necrotizing fasciitis: Systematic review and analysis of 1235 reported cases from the literature

“…2,25 In the early stages, histopathologic examination reveals superficial epidermal hyaline necrosis, dermal edema, and hemorrhage but no inflammatory cells. 10,38 The pathogenesis of necrotizing fasciitis is yet to be elucidated. 1,[34][35][36] As reflected in our analysis, the most commonly reported source of cervical necrotizing fasciitis is odontogenic (47.05%).…”

“…10 Given the robust blood supply, infection in the head and neck locality is exceedingly rare accounting for an estimated 1%-10% of cases, 11 or, as stated in another Danish study, 2 per 1 000 000 inhabitants per year. Epidemiological data spanning 10 years from the United States estimates a mortality rate of 4.8 per 1 000 000 per year with greater incidence rates in black, Hispanic, and American Indians, and a lower incidence in Asians.…”

Necrotising Fasciitis: Appearances Can Be Deceptive

“…Necrotizing fasciitis of scalp is rare, but can sometimes occur due to odontogenic infections. 21,44,[51][52][53][54][55][56][57][58][59] But in our patient, it followed trauma. The disease spread rapidly and on surgery, there was extensive necrosis of the pericranium and SMAS with induration of ear and neck; which took unusually long time to settle despite multiple debridements.…”

Laboratory Risk Indicator for Necrotizing Fasciitis of the Oro-Cervical Region (LRINEC-OC): A Possible Diagnostic Tool for Emergencies of the Oro-Cervical Region

“…NF develops concomitantly with ischemia and infection and almost always in the extremities and thoracoabdominal region. In the oro-cervical region, NF develops less likely due to the abundant blood supply [28]. The fascia of the head and neck region are comprised of areolar tissue, which is separated by the superficial cervical fascia and deep cervical fascia.…”