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. 2022 Apr;21(4):1635-1641.
doi: 10.1111/jocd.14254. Epub 2021 Jun 9.

Comparison of death and survival cervical necrotizing fasciits cases

Bilal Sizer  1 , Ümit Yılmaz  2 , Vefa Kınış  3 , Argün Ediz Yorgancılar  4
Affiliations

Comparison of death and survival cervical necrotizing fasciits cases

Bilal Sizer et al. J Cosmet Dermatol. 2022 Apr.

Abstract

Background: Cervical Necrotizing Fasciitis (CNF) is associated with a high mortality rate. The occurrence of mediastinitis with CNF may increase mortality up to 70%.

Aims: We aimed to identify the differences between surviving and deceased cases.

Methods: The present study was conducted retrospectively by scanning the files of 16 patients between the ages of 19-71 who were diagnosed with CNF. Patients were divided into two groups as the surviving patient group (SPG) and the deceased patient group (DPG). Both groups were compared in terms of age, gender, Laboratory Risk Indicator for Necrotizing Fasciitis (LRİNEC) score, duration of symptom onset to hospital admission, use of antibiotherapy prior to admission, duration of hospitalization, presence of diabetes mellitus (DM), presence of dental etiology, mediastinitis, and respiratory distress at the time of admission.

Results: Diabetes mellitus was the most common comorbid disease. 5 out of 7 deceased patients had DM. Dental events were the most common etiology. Rapid surgical debridement and airway management was the first treatment method. The most frequently isolated species in the culture was Streptococcus. 6 of 11 patients who developed mediastinitis deceased at the end of the process.

Conclusion: Dental pathologies mostly play a role in the etiology. It is obvious that dentists, another occupational group that frequently encounters this patient group, have a critical role in this process. Therefore, precise attention should be given to dental problems in patients with diabetes, and hospitalization and initiation of broad-spectrum antibiotherapy should be considered in case of suspicion of deep neck infection.

Keywords: cervical; debridement; dental; diabetes; necrotizing fasciitis.

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References

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