Fatal necrotizing fasciitis following a mandibular fracture.
Necrotizing fasciitis of the head and neck is an uncommon, insidious infection that usually occurs secondarily to odontogenic infections, although blunt and penetrating trauma can be another cause. Of 65 total reported cases of necrotizing fasciitis, 10 (15.4%) have been fatal. This article presents a case of a mandibular fracture in a severely immunocompromised elderly patient in whom delayed treatment proved fatal. The clinician must remain suspicious of any infection refractory to antibiotic therapy alone, since necrotizing fasciitis is a rapidly progressing condition with high morbidity and potential for mortality. Rapid diagnosis, surgical treatment, antibiotic therapy, medical management, nutritional support, and early detection and treatment of complications are critical elements in the management of necrotizing fasciitis.
Chin
R S
RS
Department of Surgery, Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15237, USA.
Kaltman
S I
SI
Colella
J
J
D000368:Aged; D016470:Bacteremia / Q000382:microbiology; D003131:Combined Modality Therapy; D019115:Fasciitis, Necrotizing / Q000209:etiology* / Q000382:microbiology; D017809:Fatal Outcome; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis; D006801:Humans; D016867:Immunocompromised Host; D008337:Mandibular Fractures / Q000150:complications* / Q000601:surgery; D014946:Wound Infection / Q000382:microbiology