Cervical necrotizing fasciitis: management challenges in poor resource environment
Autor: | B. C. Owughalu, H. M. Omang, Abiola Grace Adekanye, A.N. Umana, M. E. Offiong, Marcus Inyama, R. B. Mgbe |
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Rok vydání: | 2015 |
Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Nigeria Trismus Malignancy Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans General anaesthesia Fasciitis Necrotizing 030223 otorhinolaryngology Fasciitis Aged Debridement business.industry Disease Management 030206 dentistry General Medicine Length of Stay Middle Aged medicine.disease Dysphagia Anti-Bacterial Agents Surgery Survival Rate Otorhinolaryngology Etiology Female medicine.symptom business Neck |
Zdroj: | European Archives of Oto-Rhino-Laryngology. 273:2779-2784 |
ISSN: | 1434-4726 0937-4477 |
DOI: | 10.1007/s00405-015-3841-0 |
Popis: | Necrotizing fasciitis of the head and neck is a rare and potentially fatal disease. It is a bacterial infection characterized by spreading along fascia planes and subcutaneous tissue resulting in tissue necrosis and likely death. It is commonly of dental or pharyngeal origin. Factors affecting the success of the treatment are early diagnosis, appropriate antibiotics and surgical debridement. Our study showed eight patients, five males and three females with mean age of 49.25 years (range 20-71 years). Clinical presentations were a rapidly progressing painful neck swelling, fever, dysphagia and trismus. The aetiology varied from idiopathic, pharyngeal/tonsillar infection, trauma and nasal malignancy. There were associated variable comorbidities (diabetes mellitus, HIV infection, hypertension and congestive cardiac failure). All the patients received early and aggressive medical treatment. The earliest time of surgery was 12 h after admission because of the poor financial status of patients. Three cases came in with complications of the disease and were not fit for extensive debridement under general anaesthesia. For them limited and reasonable bed side debridement was done. Mortality was 50 % from multiple organ failure, HIV encephalopathy, aspiration pneumonitis and septicemia. The duration of hospital stay for the patients that died ranged from 1 to 16 days and 4 to 34 days for the survivor. Our study heightens awareness and outlines the management challenges of necrotizing fasciitis of the head and neck in a poor resource setting. |
Databáze: | OpenAIRE |
Externí odkaz: |
Abstrakt: | Necrotizing fasciitis of the head and neck is a rare and potentially fatal disease. It is a bacterial infection characterized by spreading along fascia planes and subcutaneous tissue resulting in tissue necrosis and likely death. It is commonly of dental or pharyngeal origin. Factors affecting the success of the treatment are early diagnosis, appropriate antibiotics and surgical debridement. Our study showed eight patients, five males and three females with mean age of 49.25 years (range 20-71 years). Clinical presentations were a rapidly progressing painful neck swelling, fever, dysphagia and trismus. The aetiology varied from idiopathic, pharyngeal/tonsillar infection, trauma and nasal malignancy. There were associated variable comorbidities (diabetes mellitus, HIV infection, hypertension and congestive cardiac failure). All the patients received early and aggressive medical treatment. The earliest time of surgery was 12 h after admission because of the poor financial status of patients. Three cases came in with complications of the disease and were not fit for extensive debridement under general anaesthesia. For them limited and reasonable bed side debridement was done. Mortality was 50 % from multiple organ failure, HIV encephalopathy, aspiration pneumonitis and septicemia. The duration of hospital stay for the patients that died ranged from 1 to 16 days and 4 to 34 days for the survivor. Our study heightens awareness and outlines the management challenges of necrotizing fasciitis of the head and neck in a poor resource setting. |
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ISSN: | 14344726 09374477 |
DOI: | 10.1007/s00405-015-3841-0 |