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Cervical necrotizing fasciitis: Systematic review and analysis of 1235 reported cases from the literature
Author(s) -
Gunaratne Dakshika A.,
Tseros Evan A.,
Hasan Zubair,
Kudpaje Akshay S.,
Suruliraj Anand,
Smith Mark C.,
Riffat Faruque,
Palme Carsten E.
Publication year - 2018
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25184
Subject(s) - fasciitis , medicine , mediastinitis , etiology , surgery , medline , political science , law
Background Cervical necrotizing fasciitis is a progressive soft tissue infection with significant morbidity and mortality. Methods A case review of cervical necrotizing fasciitis managed at our institution (2007‐2017) and a systematic review of PubMed, MEDLINE, and EMBASE databases using the algorithm “(cervical OR neck) AND necrotizing fasciitis.” Results There were 1235 cases from 207 articles which were included in our clinical review. Mean age for cervical necrotizing fasciitis was 49.1 years (64.23% men). Etiology was odontogenic (47.04%), pharyngolaryngeal (28.34%), or tonsillar/peritonsillar (6.07%). There were 2 ± 0.98 organisms identified per patient; streptococci (61.22%), staphylococci (18.09%), and prevotella (10.87%). There were 2.5 ± 3.22 surgical debridements undertaken. Descending necrotizing mediastinitis occurred in 31.56% of patients. Mean length of stay in the hospital was 29.28 days and overall mortality was 13.36%. Conclusion Physicians and surgeons must be vigilant of the diagnosis of cervical necrotizing fasciitis as early clinical findings may be subtle and prompt identification to facilitate aggressive intervention is required to preclude catastrophic local and systemic morbidity and mortality.