Cervical necrotizing fasciitis: systematic review and analysis of 1235 reported cases from the literature

Dakshika A. Gunaratne*, Evan A. Tseros, Zubair Hasan, Akshay S. Kudpaje, Anand Suruliraj, Mark C. Smith, Faruque Riffat, Carsten E. Palme

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

23 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)2094-2102
Number of pages9
JournalHead and Neck
Volume40
Issue number9
DOIs
Publication statusPublished - 1 Sep 2018

Keywords

  • cervical necrotizing fasciitis
  • head and neck
  • mortality
  • necrotizing fasciitis
  • sequelae

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