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J R Coll Surg Edinb ; 42(6): 410-3, 1997 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-9448399

RESUMEN

Eight cases of cervical necrotizing fasciitis are presented. Three were odontogenic, two were pharyngeal in origin and three were primary or idiopathic. Soft tissue gas was recognized in four patients. The bacteriology showed streptococci on the top of the list (50%), while for the idiopathic cases, it was monomicrobial and caused by staphylococci. Third generation cephalosporin and metronidazole represent good initial empirical antibacterial coverage. Histopathologically, all cases showed extensive necrosis of the debrided fascia and vascular thrombosis of the dermal vessels. The mortality rate was 3/8 (37.5%). Early diagnosis of cervical necrotizing fasciitis and initiation of definitive therapy in an intensive care environment is essential to minimize mortality. It is also important to recognize that this devastating infection may occur spontaneously, and it should be suspected in patients with unexplained soft tissue pain and tenderness.


Asunto(s)
Causas de Muerte , Fascitis Necrotizante/mortalidad , Adulto , Anciano , Bacteroides/efectos de los fármacos , Bacteroides/aislamiento & purificación , Cefalosporinas/farmacología , Fascitis Necrotizante/diagnóstico , Fascitis Necrotizante/microbiología , Fascitis Necrotizante/terapia , Femenino , Humanos , Klebsiella/efectos de los fármacos , Klebsiella/aislamiento & purificación , Tiempo de Internación , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Insuficiencia Multiorgánica/mortalidad , Cuello , Estudios Retrospectivos , Choque Séptico/mortalidad , Staphylococcus/efectos de los fármacos , Staphylococcus/aislamiento & purificación , Streptococcus/efectos de los fármacos , Streptococcus/aislamiento & purificación , Tasa de Supervivencia , Tomografía Computarizada por Rayos X , Traqueostomía , Reino Unido/epidemiología
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