Cervical necrotizing fasciitis of nonodontogenic origin: case report and review of literature

Am J Emerg Med. 2014 Nov;32(11):1441.e5-6. doi: 10.1016/j.ajem.2014.04.018. Epub 2014 Apr 18.

Abstract

Cervical necrotizing fasciitis (CNF) is a potentially fatal infection characterized by generalized necrosis of the cervical fascia that progresses rapidly. The incidence of this entity corresponds to 2.6% of all infections of the head and neck. The most frequent primary origin is dental infection, although other causes exist that should be evaluated.Delay in the diagnosis of this entity may lead to rapid progression and fatal outcome. Patients often present immunosuppression or systemic diseases that predispose them to this pathology. Cervical necrotizing fasciitis is associated with mortality rates of 7% to 20% depending on the extension of the cervical lesion. The highest rates correspond to cases that progress to mediastinitis or septic shock, which are the main and most frequent complications. Early detection and adequate emergency treatment are critical in the management of these patients and may reduce morbimortality and improve survival. The emergency services should be prepared to manage such cases efficiently, through a multidisciplinary treatment by coordinating emergency surgery with critical support and clinical stabilization of patients.We present a case of CNF of non odontogenic origin managed in our hospital.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Debridement
  • Diagnosis, Differential
  • Fasciitis, Necrotizing / diagnosis*
  • Fasciitis, Necrotizing / surgery*
  • Humans
  • Male
  • Middle Aged
  • Neck*
  • Risk Factors
  • Tracheotomy