title: The value of early intervention and a multidisciplinary approach in the management of necrotizing fasciitis of the neck and anterior mediastinum of odontogenic origin.
abstract: Necrotizing fasciitis (NF) is a serious clinical condition, which, if diagnosed late, invariably leads to a fatal outcome. A high index of suspicion of the presenting clinical signs and symptoms, supported by knowledge of the clinicopathologic processes that underlie its aggressive nature, should prompt early surgical intervention. Ultimately, the success of treatment requires a robust clinical pathway in which all members of the health care team are aligned by their skill sets and competencies to manage NF. This report describes the management of a case of a young man with aggressive NF of odontogenic origin affecting the neck and anterior mediastinum. A multidisciplinary approach brought about early recognition of the disease and surgical intervention, the use of frozen section biopsies to determine the extent of fascial spread, and aggressive debridement of the affected tissue. Teamwork, critical thinking, and situational awareness ensured that the patient received optimum care in a timely manner. The psychological, clinical, radiologic, pathologic, and microbiological aspects of the patient's care are presented with a literature review.
authors: Consultant and Head, Maxillofacial Surgery Service, Al Rahba Hospital, Abu Dhabi, UAE; formerly at Mafraq Hospital, Abu Dhabi. Electronic address: jkmfprs@gmail.com.
authors: Joseph Kamal
authors: JK
authors: Muhammad
authors: Consultant, Department of General Surgery, Mafraq Hospital, Abu Dhabi, UAE.
authors: Hana
authors: H
authors: Almadani
authors: Consultant and Head, Department of Maxillofacial Surgery, Mafraq Hospital, Abu Dhabi, UAE.
authors: Bader A
authors: BA
authors: Al Hashemi
authors: Consultant, Department of Anatomic Pathology, Mafraq Hospital, Abu Dhabi, UAE.
authors: Muneezeh
authors: M
authors: Liaqat
mesh_terms: D000328:Adult; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000534:rehabilitation / Q000628:therapy; D006801:Humans; D008297:Male; D008482:Mediastinum / Q000473:pathology*; D009333:Neck / Q000473:pathology*; D013297:Streptococcus pyogenes / Q000302:isolation & purification