Craniocervical necrotizing fasciitis: critical factors in management

Necrotizing fasciitis involving the head and neck is rare. The authors describe two such patients treated at their institution and analyse 39 cases reported in the literature. This entity may be divided into two groups based on the site of origin of the infection: group 1 (13 cases) infections, orig...

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Bibliographic Details
Published inCanadian journal of surgery Vol. 30; no. 1; p. 61
Main Authors Nallathambi, M N, Ivatury, R R, Rohman, M, Rao, P M, Stahl, W M
Format Journal Article
LanguageEnglish
Published Canada 01.01.1987
Subjects
Adult
Bacterial Infections
Craniocerebral Trauma - complications
Eyelid Diseases - complications
Fasciitis - diagnosis
Fasciitis - etiology
Fasciitis - pathology
Fasciitis - therapy
Female
Head
Humans
Male
Mandibular Fractures - complications
Neck
Necrosis
Scalp Dermatoses - complications
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Summary:Necrotizing fasciitis involving the head and neck is rare. The authors describe two such patients treated at their institution and analyse 39 cases reported in the literature. This entity may be divided into two groups based on the site of origin of the infection: group 1 (13 cases) infections, originating in the scalp and eyelids, mostly secondary to trauma, do not progress rapidly, respond well to medical and operative measures and result in minimal permanent disability. These infections usually are caused by hemolytic streptococci and Staphylococcus aureus. Group 2 (28 cases) infections, originating in the face or neck and mostly complications of dental and pharyngeal sepsis, progress rapidly to adjoining sites including the chest wall and mediastinum. These infections are caused by a wide variety of microorganisms including anaerobes; fatal complications are frequent and the death rate is high (32%). Early and very aggressive débridement and drainage are mandatory and should be repeated if warranted.
ISSN:0008-428X
1488-2310