- Mohammedi I, Ceruse P, Duperret S, et al (Edouard Herriot Hosp, Lyon, France)
Cervical Necrotizing Fasciitis: 10 Years Experience at a Single Institution
Intensive Care Med 25: 829-834, 1999
Life threatening infections most frequently originate from supportive complications of dental or oropharyngeal infections.
20 consecutive patients with the diagnosis of this fasciitis admitted in the intensive care unit between 1987 to 1998 were reviewed retrospectively. The original sources of infection were (6 patients) dental, (6) pharyngeal, (4) iatrogenic, (1) posttraumatic, and (3) unknown origin.
The most commonly implicated organisms were Streptococcus prevotella and Peptostreptococcus: 25% of the initial infection sites revealed the presence of mixed flora of anaerobic and aerobic bacteria. 3 patients died.
Conclusion : Prompt surgical debridement was considered and appropriate antibiotics and intensive care support resulted in better outcome. None had hyperbaric treatment.
According to R. A. Otto, early and adequate repeated debridement to viable margins are necessary. Though the authors have not used hyperbaric oxygen, it is used routinely in severe cases.