Cervical necrotizing fasciitis: descriptive, retrospective analysis of 59 cases treated at a single center.
To provide retrospective, descriptive information on patients with cervical necrotizing fasciitis treated at a single center during the years 1998-2014, and to evaluate the outcome of a newly introduced treatment strategy. Retrospective analysis of clinical data obtained from medical records. Mortality, pre-morbidity, severity of illness, primary site of infection, type of bacteria, time parameters. The observed 3-month mortality was 6/59 (10 %). The most common initial foci of the infection were pharyngeal, dental or hypopharyngeal. The most common pathogen was Streptococcus milleri bacteria within the Streptococcus anginosus group (66 % of the cases). Using a combined treatment with early surgical debridement combined with hyperbaric oxygen treatment, it is possible to reduce the mortality rate among patients suffering from cervical necrotizing fasciitis, compared to the expected mortality rate and to previous historical reports. Data indicated that early onset of hyperbaric oxygen treatment may have a positive impact on survival rate, but no identifiable factor was found to prognosticate outcome.
Department of Otorhinolaryngology, Region Gotland, Visby Lasarett, Sankt Göransgatan 5, 621 55, Visby, Sweden. johanna.elander@gotland.se.|Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden. johanna.elander@gotland.se.
Johanna
http://orcid.org/0000-0001-8056-4911
J
Elander
Department of Anaesthesia, Surgical Services and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
Michael
M
Nekludov
Department of Anaesthesia, Surgical Services and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.|Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Agneta
A
Larsson
Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden.
Britt
B
Nordlander
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Staffan
S
Eksborg
Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden.
Jonas
J
Hydman
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D003646:Debridement; D019115:Fasciitis, Necrotizing / Q000382:microbiology / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D009333:Neck; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013290:Streptococcal Infections / Q000382:microbiology / Q000628:therapy; D034366:Streptococcus anginosus; D034364:Streptococcus milleri Group
D000900:Anti-Bacterial Agents
Cervical infection; Fasciitis; Hyperbaric oxygen treatment