Cervical necrotizing fasciitis: report of clinical cases

Introduction: Necrotizing fasciitis (NF) is a rare soft tissue infection, usually polymicrobial, which causes necrosis of the fascia and subcutaneous tissue disorders not involving the skin1,2. It is characterized by rapid progression and destruction of the soft tissues of proportion to signs and clinical symptoms. The predisposing factors include diabetes mellitus, steroid therapy, chronic renal failure, cirrhosis, obesity, cancer, hypothyroidism, atherosclerosis, alcoholism, drug abuse, age and state of malnutrition.3,4 The states of immunosuppression plays an important role in determining the initiation, progression, and disease outcomes. A prompt diagnosis and immediate aggressive surgical debridement of all compromised tissues are critical to reducing morbidity and mortality in this type of infection.5 Materials and Methods: The study, unicentric and retrospective, was conducted at the Hospital "Santa Maria alle Scotte" in Siena (Italy). WE report patients'age, sex, medical status, origin of infection, bacteriology, surgical interventions, complications, survival, and other clinical parameters. Results and Conclusions: The treatment of NF may be challenging and the keys to successful management appear to provide for the early detection of infection, high doses of appropriate antimicrobial therapy, and surgical intervention with radical debridement of necrotic tissue. Surgery remain the mainstay of treatment for NF.6 1.Changchien CH, Chen YY, Chen SW, Chen WL, Tsay JG, Chu C Retrospective study of necrotizing fasciitis and characterization of its associated Methicillin-resistant Staphylococcus aureus in Taiwan. BMC Infect Dis. 2011 Oct 31;11(1):297. 2. Lorenzini G, Picciotti M, Di Vece L, Pepponi E, Brindisi L, Vessio V, Maffei M, Viviano M.Cervical necrotizing fasciitis of odontogenic origin involving the temporal region - A case report. J Craniomaxillofac Surg. 2011 Dec;39(8):570-3 3. Banerjee AR, Murty GE, Moir AA. Cervical necrotizing fasciitis: a distinct clinicopathological entity? J Laryngol Otol. 1996 Jan;110(1):81-6. 4. Wong CH, Kurup A, Wang YS, Heng KS, Tan KC: Four cases of necrotizing fasciitis caused by Klebsiella species. Eur J Clin Microbiol Infect Dis 23(5): 403e407, 2004 5. Hunter J, Quarterman C, Waseem M, Wills A. Diagnosis and management of necrotizing fasciitis. Br J Hosp Med (Lond). 2011 Jul;72(7):391-5. 6. Tung-Yiu W, Jehn-Shyun H, Ching-Hung C, Hung-An C.Cervical necrotizing fasciitis of odontogenic origin: a report of 11 cases. J Oral Maxillofac Surg. 2000 Dec;58(12):1347-52