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Novel management of cervical necrotising fasciitis in a developing country: case report

Published online by Cambridge University Press:  12 October 2010

A Salisu ,
A A Adeosun ,
N H Emma-Nzekwue  and
S B Abubakar
A Salisu*
Affiliation:
Department of ENT, University College Hospital, Ibadan, Nigeria
A A Adeosun
Affiliation:
Department of ENT, University College Hospital, Ibadan, Nigeria
N H Emma-Nzekwue
Affiliation:
Department of ENT, University College Hospital, Ibadan, Nigeria
S B Abubakar
Affiliation:
Department of Microbiology, University College Hospital, Ibadan, Nigeria
*
Address for correspondence: Dr A Salisu, Consultant ENT Surgeon, Federal Medical Centre, Gusau, Zamfara State, Nigeria E-mail: [email protected]
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Abstract

Objective:

We report a rare case of cervical necrotising fasciitis arising from poorly managed acute tonsillitis.

Case report:

A 23-year-old woman presented with a two-week history of fever and an eight-day history of painful neck swelling. Nine days before presentation, she had received digital manipulation of her throat by a neighbour, which had worsened her throat pain. There was associated progressive generalised neck swelling, odynophagia, dysphagia and dyspnoea. An X-ray of the neck soft tissue showed multiple gas collections.

Conclusion:

Cervical necrotising fasciitis is rare and usually odontogenic in origin. It is associated with a high mortality rate. Our patient responded to aggressive daily bedside wound debridements and dressings, appropriate intravenous antibiotics and high-protein nutritional support. In this way, exploration under general anaesthesia was avoided, in a developing country with limited facilities.

Keywords

CervicalNecrotizing FasciitisAcute TonsillitisConscious SedationDebridementNecrotic Neck Wound
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 1 , January 2011 , pp. 93 - 95
Copyright
Copyright © JLO (1984) Limited 2010

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References

1 Gallia, LJ, Johnson, JT. Cervical necrotizing fasciitis. Otolaryngol Head Neck Surg 1981;89:935–7CrossRefGoogle ScholarPubMed
2 Kantu, S, Har-El, G. Cervical necrotizing fasciitis. Ann Otol Rhinol Laryngol 1997;106:965–70CrossRefGoogle ScholarPubMed
3 Bahu, SJ, Shibuya, TY, Meleca, RJ, Mathog, RH, Yoo, GH, Stachler, RJ et al. Craniocervical necrotizing fasciitis: an 11-year experience. Otolaryngol Head Neck Surg 2001;125:245–52CrossRefGoogle Scholar
4 Maisel, RH, Karlen, R. Cervical necrotizing fasciitis. Laryngoscope 1994;104:795–8CrossRefGoogle ScholarPubMed
5 Spankus, EM, Flint, PW, Smith, RJ, Miller, RH. Craniocervical necrotizing fasciitis. Otolaryngol Head Neck Surg 1984;92:261–5CrossRefGoogle ScholarPubMed
6 Tovi, F, Fliss, DM, Zirkin, HJ. Necrotizing soft-tissue infections in the head and neck: a clinicopathological study. Laryngoscope 1991;101:619–25CrossRefGoogle ScholarPubMed
7 Reed, JM, Anand, VK. Odontogenic cervical necrotizing fasciitis with intrathoracic extension. Otolaryngol Head Neck Surg 1992;107:596–600CrossRefGoogle ScholarPubMed
8 Stone, HH, Martin, JD. Synergistic necrotizing cellulitis. Ann Surg 1972;175:702–11CrossRefGoogle ScholarPubMed
9 McHenry, CR, Brandt, CP, Piotrowske, JJ, Jacobs, DG, Malangoni, MA. Idiopathic necrotizing fasciitis: recognition, incidence and outcome of therapy. Am Surg 1994;60:490–4Google ScholarPubMed
10 Brook, I, Frazier, EH. Clinical and microbiological features of necrotizing fasciitis. J Clin Microbiol 1995;33:2382–7CrossRefGoogle ScholarPubMed
11 Becker, M, Zbären, P, Hermans, R, Becker, CD, Marchal, F, Kurt, AM et al. Necrotizing fasciitis of the head and neck: role of CT in diagnosis and management. Radiology 1997;202:471–6CrossRefGoogle ScholarPubMed