[Cervical necrotizing fasciitis:clinicopathological aspects].

INTRODUCTION

Necrotising fasciitis is a potentially fatal fulminant infection of the subcutaneous tissues.

METHODS

Our series comprised 15 patients with severe necrotising fasciitis during a 6-year period (1994-1999) at the surgical and ENT department of the Cantonal Hospital in Lucerne.

RESULTS

In 4 cases, the necrotising infection occurred in the head and neck, beginning with a mastoiditis, pharyngitis, tongue swelling and infection of the upper eyelid. The bacteria cultures showed in 3 cases streptococcus of group A, in one case there was a mixed flora. All patients underwent a surgical intervention combined with antibiotics, intensive care was also necessary. All 4 patients with necrotising fasciitis in head and neck survived, 3 of the 11 surgical cases died because of multiorgan failure.

DISCUSSION: The high mortality in necrotising fasciitis can only be influenced if diagnosed and treated very early. There often is a difference between the local infection sings and the patient's condition. The treatment includes a sudden surgical intervention combined with antibiotic therapy and intensive care.