Retrospective evaluation of necrotizing fasciitis in University College Hospital, Ibadan.

CONTEXT: Cervicofacial necrotizing fasciitis (CNF), although a potentially fatal fulminant infection has been largely under-reported in the dental literature.

AIMS: To report our experience with cases seen and treated at the University College Hospital, Ibadan, Nigeria.

SETTINGS AND

DESIGN

A descriptive retrospective clinical study.

MATERIALS AND

METHODS

A retrospective survey of cases treated between January 2002 and January 2007 was done. Diagnosis of CNF was established by fascia necrosis found on surgical exploration. Patients' age, sex, medical status, etiology of infection, bacteriology, and treatment received and complications were reviewed.

STATISTICAL ANALYSIS USED: SPSS version 15.

RESULTS

Of the 48 cases of cervicofacial infection admitted during the study period, only 12 cases of CNF were found. Male:Female ratio was 4:8. The mean age of patients was 58.83 ± 11.91 years while the age range was 42-83 years. Those that had immunocompromised medical conditions included three cases each of diabetes mellitus and chronic nutritional anaemia and one case of retroviral infection. Mixed bacterial isolates of anaerobes and enterobacteriaceae were found in 10 cases while beta hemolytic streptococci were the sole isolate in two cases. All patients had serial debridement combined with intravenous antibiotic medications. Complications included anterior chest wall infection in three patients and one case of pleural effusion. The only mortality occurred in the patient with retroviral infection.

CONCLUSIONS

We advocate early recognition, surgical debridement and intensive medical care for treatment of CNF in order to reduce morbidity and mortality from this condition.