Craniocervical necrotizing fasciitis of odontogenic origin with mediastinal extension.
We review an interesting case of craniocervical necrotizing fasciitis with thoracic extension in an immunocompetent 44-year-old man. The patient underwent aggressive medical and surgical management during a long hospitalization. Multiple surgical debridements, including transcervical mediastinal debridement, and eventually a thoracotomy for mediastinal abscess were required. The patient eventually recovered, and 3 months later he showed no sign of complications or recurrence. Craniocervical necrotizing fasciitis is a fulminant soft-tissue infection, usually of odontogenic origin, that requires prompt identification and treatment to ensure survival. Broad-spectrum intravenous antibiotics, aggressive surgical debridement and wound care, hyperbaric oxygen, and good intensive care are the mainstays of treatment.
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, George Washington University Medical Center, Washington, DC 20037, USA. jde@gwu.edu
John D
JD
Edwards
Nader
N
Sadeghi
Farzad
F
Najam
Mark
M
Margolis
D000038:Abscess / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D000328:Adult; D003646:Debridement / Q000379:methods*; D019115:Fasciitis, Necrotizing / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D006257:Head / Q000601:surgery; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D008482:Mediastinum / Q000473:pathology / Q000601:surgery; D009333:Neck / Q000601:surgery; D010508:Periodontal Abscess / Q000150:complications* / Q000188:drug therapy; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D014057:Tomography, X-Ray Computed