[Cervical necrotizing fasciitis:clinicopathological aspects].
BACKGROUND
Necrotising fasciitis is a potentially fatal fulminant infection of the subcutaneous tissues.


METHODS
Our series comprised 15 patients with severe necrotising fasciitis during a 6-year period (1994-1999) at the surgical and ENT department of the Cantonal Hospital in Lucerne.


RESULTS
In 4 cases, the necrotising infection occurred in the head and neck, beginning with a mastoiditis, pharyngitis, tongue swelling and infection of the upper eyelid. The bacteria cultures showed in 3 cases streptococcus of group A, in one case there was a mixed flora. All patients underwent a surgical intervention combined with antibiotics, intensive care was also necessary. All 4 patients with necrotising fasciitis in head and neck survived, 3 of the 11 surgical cases died because of multiorgan failure.


CONCLUSIONS
The high mortality in necrotising fasciitis can only be influenced if diagnosed and treated very early. There often is a difference between the local infection sings and the patient's condition. The treatment includes a sudden surgical intervention combined with antibiotic therapy and intensive care.
Nuber
R
R
Klinik für Hals-, Nasen- und Ohrenheilkunde, Hals- und Gesichtschirurgie, Kantonsspital Luzern.
Müller
W
W
D000328:Adult; D003131:Combined Modality Therapy; D019115:Fasciitis, Necrotizing / Q000473:pathology* / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008417:Mastoiditis / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D010612:Pharyngitis / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D014060:Tongue Diseases / Q000209:etiology / Q000503:physiopathology