Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-23T14:20:14.290Z Has data issue: false hasContentIssue false
  • English
  • Français

Synergistic necrotizing cellulitis resulting from peri-tonsillar abscess

Published online by Cambridge University Press:  29 June 2007

P. J. Hadfield ,
M. Motamed  and
G. W. Glover
P. J. Hadfield*
Affiliation:
Department of Otolaryngology, Northwick Park Hospital, Harrow, Middlesex, UK.
M. Motamed
Affiliation:
Department of Otolaryngology, Northwick Park Hospital, Harrow, Middlesex, UK.
G. W. Glover
Affiliation:
Department of Otolaryngology, Northwick Park Hospital, Harrow, Middlesex, UK.
*
Address for correspondence: Miss P. J. Hadfield, F.R.C.S., Department of Otolaryngology, Charing Cross Hospital, Fulham Palace Road, London W6 8RF.
Get access Rights & Permissions [Opens in a new window]

Abstract

This case demonstrates the rare but potentially fatal condition of synergistic necrotizing cellulitis of the head and neck. Although similar to necrotizing fasciitis, this is more extreme as it also destroys muscle. Peri-tonsillar abscess is a recognized cause, but has not previously been described in this country, however it is a condition commonly referred to otolaryngologists and awareness of the complication of synergistic necrotizing cellulitis is necessary to allow early recognition and prompt treatment. This should be by broad-spectrum intravenous antibiotics with extensive surgical debridement and drainage procedures repeated as necessary. Although this case had a successful outcome, many patients do not survive, particularly if treatment is delayed or inadequate.

Keywords

Peritonsillar abscessCellulitis, synergistic necrotizingFasciitis, necrotizing
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 110 , Issue 9 , September 1996 , pp. 887 - 890
Copyright
Copyright © JLO (1984) Limited 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Balcerak, R. J., Sisto, J. M., Bosack, R. C. L. (1988) Cervicofacial necrotizing fasciitis: report of three cases and literature review. Journal of Oral and Maxillofacial Surgery 46: 450–459.CrossRefGoogle ScholarPubMed
Burge, T. B. (1995) Necrotizing fasciitis - the hazards of delay. Journal of the Royal Society of Medicine 88: 342–343.Google ScholarPubMed
Gaukroger, M. C. (1992) Cervicofacial necrotizing fasciitis. British Journal of Oral and Maxillofacial Surgery 30(2): 111–114.CrossRefGoogle Scholar
Greinwald, J. H., Wilson, J. F., Haggerty, P. J. (1995) Peritonsillar abscess: an unlikely cause of necrotizing fasciitis. Annals of Otology Rhinology and Laryngology 104: 133–137.CrossRefGoogle ScholarPubMed
Herr, R. D., Murdock, R. T., Davis, R. K. (1991) Serious soft tissue infections of the head and neck. American Family Physician 44(3): 878–888.Google ScholarPubMed
Kaplan, D. M., Fliss, D. M., Shulman, H., Lieberman, A. (1995) Computed tomographic detection of necrotizing soft tissue infection of dental origin. Annals of Otology, Rhinology and Laryngology 104: 164–166.CrossRefGoogle ScholarPubMed
Kronish, J. W., McLeish, W. M. (1991) Eyelid necrosis and periorbital necrotizing fasciitis. Report of a case and review of the literature. Ophthalmology 98(1): 1292–1298.CrossRefGoogle ScholarPubMed
Kurakin, A. V., Karapetiam, I. S., Volozhin, A. I., Sel'tsovskaia, G. D., Sudorgin, S. S., Asnina, S. A., Smirnova, E. N., Afanas'eva, E. A. (1993) The efficacy of using hyperbaric oxygen in different forms of an inflammatory process in the maxillofacial area. Stomatologiia - Moskia 72(2): 30–32.Google ScholarPubMed
Lalwani, A. K., Kaplan, M. J. (1991) Mediastinal and thoracic complications of necrotizing fasciitis of the head and neck. Head and Neck Surgery 13: 531–539.Google ScholarPubMed
Maisel, R. H., Karlen, R. (1994) Cervical necrotizing fasciitis. Laryngoscope 104(7): 795–798.CrossRefGoogle ScholarPubMed
Morrow, J. S., Gianoli, G. J. (1993) Craniocervical necrotizing fasciitis. Journal of Los Angeles State Medical Society 145(7): 297–300.Google ScholarPubMed
Palchun, V. T., Kriukov, A. I., Vladimirova, V. V., Muratov, D. L. (1993) Para-tonsillitis-debatable questions of treatment techniques (1993). Vestnik Otorinolaryngologii 4: 28–32.Google Scholar
Peled, M., Rubin, A., Laufer, D. (1994) Cervical necrotizing fasciitis. Harefuah 126(11): 651–654.Google ScholarPubMed
Rippe, D. H. (1991) Intensive Care Medicine, 2nd Edition, Little, Brown and Co., Boston, MA, pp. 1337–1339.Google Scholar
Rouse, T. M., Malagoni, M. A., Schulte, W. J. (1982) Necrotizing fasciitis: a preventable disaster. Surgery 92: 765–770.Google ScholarPubMed
Smith, G. A., Hemingway, W. G. (1978) Infections of the head and neck. Medical Times 106: 33–39.Google ScholarPubMed
Spankus, E. M., Flint, P. W., Smith, R. J. H., Millar, R. H. (1984) Craniocervical necrotizing fasciitis. Otolaryngology - Head and Neck Surgery 92: 261–265.CrossRefGoogle ScholarPubMed
Stone, H. H., Martin, J. D. (1972) Synergistic necrotizing cellulitis. Annals of Surgery 175: 702.CrossRefGoogle ScholarPubMed
Tovi, F., Flis, D. M., Zirkin, H. J. (1991) Necrotizing softtissue infections in the head and neck; a clinicopathological study. Laryngoscope 101: 619–625.CrossRefGoogle ScholarPubMed
Ward, R. G., Walsh, M. S. (1991) Necrotizing fasciitis: 10 years' experience in a district general hospital. British Journal of Surgery 78: 488.CrossRefGoogle Scholar
Wenig, B. L., Shikowitz, M. J., Abramson, A. L. (1984) Necrotizing fasciitis as a lethal complication of peritonsillar abscess. Laryngoscope 94: 1576–1579.CrossRefGoogle ScholarPubMed
Williams, S. R., Carruth, J. A., Brightwell, A. P. (1992) Necrotizing fasciitis of the face without significant trauma. Clinical Otolaryngology 17: 344–350.CrossRefGoogle ScholarPubMed
Wills, P. I., Vernon, R. P. Jr. (1981) Complications of space infections of the head and neck. Laryngoscope 91: 1126–1136.CrossRefGoogle ScholarPubMed
Wilson, B. (1952) Necrotizing fasciitis. American Surgeon 18: 416–431.Google ScholarPubMed
Yamaoka, M., Furusawa, K., Uematsu, T., Yasuda, K. (1994) Early evaluation of necrotizing fasciitis with use of CT. Journal of Craniomaxillofacial Surgery 22(5): 268–271.CrossRefGoogle ScholarPubMed
Zakharov, I. S., Orlova, N. V. (1990) Anaerobic nonclostridial microflora in necrotic phlegmons of the face and neck. Soviet Medicine 10: 110–113.Google Scholar