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Cervical necrotizing fasciitis
Author(s) -
Maisel Robert H.,
Karlen Richard
Publication year - 1994
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-199407000-00003
Subject(s) - medicine , fasciitis , clindamycin , metronidazole , surgery , anaerobic bacteria , airway , cephalosporin , bacteriology , antibiotics , throat , odontogenic , pathology , microbiology and biotechnology , bacteria , biology , genetics
Abstract Nine cases of cervical necrotizing faciitis are presented. Five were odontogenic, three were pharyngeal in origin, and one developed from a soft‐tissue spider bite. The bacteriology represented a polyculture of gram‐positive, gram‐negative, as well as anaerobic bacteria, and initial medical treatment by third‐generation cephalosporin and metronidazole or clindamycin was successful and is recommended. Airway control is necessary early, as is a wide exploration of the fascial spaces of the neck, with frequent reexploration in either the operating room or at the bedside to evaluate the effects of treatment and to prevent further progression of the disease. Intensive medical support is crucial, and hyperbaric oxygen is advised for patients who are deteriorating under standard therapy.