title: Cervical necrotizing fasciitis due to methicillin-resistant Staphylococcus aureus: a case report.
abstract: Cervical necrotizing fasciitis is an uncommon but potentially fatal infection characterized by rapidly progressive, widespread necrosis of the superficial fascia. The authors report a case of cervical necrotizing fasciitis of odontogenic origin in a male with uncontrolled diabetes mellitus. An early diagnosis was based on clinical examination, confirmed by computed tomography (CT) scan, which showed multiple collections of air in the left submandibular, submental and cervical region. Broad spectrum antibiotic therapy was started quickly followed by surgical drainage and debridement. Pus culture was positive for methicillin-resistant Staphylococcus aureus. Four days after admission, mediastinitis was revealed by CT and drainage was conducted through a transcervical incision. The patient was treated successfully with antimicrobial therapy, repeated surgical debridement and supportive care.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China.
authors.forename: W-J
authors.initials: WJ
authors.lastname: Zhang
authors.forename: X-Y
authors.initials: XY
authors.lastname: Cai
authors.forename: C
authors.initials: C
authors.lastname: Yang
authors.forename: L-N
authors.initials: LN
authors.lastname: Zhou
authors.forename: M
authors.initials: M
authors.lastname: Cai
authors.forename: X-F
authors.initials: XF
authors.lastname: Lu
authors.forename: L-Y
authors.initials: LY
authors.lastname: Zheng
authors.forename: B
authors.initials: B
authors.lastname: Jiang
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D003646:Debridement; D048909:Diabetes Complications / Q000382:microbiology* / Q000628:therapy; D003920:Diabetes Mellitus / Q000276:immunology / Q000382:microbiology; D019115:Fasciitis, Necrotizing / Q000209:etiology / Q000382:microbiology* / Q000628:therapy; D005491:Focal Infection, Dental / Q000150:complications* / Q000382:microbiology; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000150:complications / Q000382:microbiology* / Q000628:therapy; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D009333:Neck; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents