CASE REPORT   

European Journal of Oral and Maxillofacial Surgery 2018 August;2(2):34-7

DOI: 10.23736/S2532-3466.18.00136-4

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Necrotizing fasciitis of the head and neck

Gianluca GIUFFRÈ ✉, Alfonso NAPOLITANO, Salvatore DE VIVO, Vincenzo FARINA, Gianluigi FALLACARA, Franco PELUSO

Department of Oral and Maxillofacial Surgery, SS. Anna e Sebastiano Hospital, Caserta, Italy

Necrotizing fasciitis (NF) of the head and neck is an uncommon, rapidly-spreading soft tissue infection of polymicrobial origin characterized by extensive necrosis and gas formation in the subcutaneous tissue and superficial fascia. This condition most frequently affects thorax, abdominal wall, extremities, perineum and groin, but according to recent literature the head and neck area is also involved with increasing frequency. Because of its rapid progression and high mortality, it is essential that the patient is diagnosed and treated early. With the progression of this disease, myonecrosis and mottling of the skin occur because of thrombosis of feeding vessels as they pass through the infected fascial planes. If early surgical treatment is not performed, necrotizing fasciitis invariably leads to systemic toxicity, multisystem organ failure, and eventual death. The disease is caused by a mixed aerobic-anaerobic infection. Patients with immunocompromised status like diabetes mellitus, cancer, alcoholism, vascular insufficiencies, organ transplants, HIV or neutropenia are prone to this type of infection. We report a case of necrotizing fasciitis in a 53-year-old male having diabetes mellitus. The best approach in the management of this condition is early diagnosis, adequate antibiotic treatment and local control of the lesion through surgical medications, which may often need to be repeated several times.

KEY WORDS: Necrotizing fasciitis - Head and neck neoplasms - Necrosis - Infection