Cervical necrotizing fasciitis and descending necrotizing mediastinitis in a patient affected by neglected peritonsillar abscess: A case of medical negligence

Bono, Giovanna; Argo, Antonina; Zerbo, Stefania; Triolo, Valentina; Procaccianti, Paolo

doi:10.1016/j.jflm.2007.12.008

Cited by 18 publications

(14 citation statements)

References 19 publications

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“…The fact that these teeth reach beneath the region where the mylohyoid muscle sticks to the mandibula enables infections caused by these teeth to reach the submandibular region. The infection may progress to the skull base in the upper region, and the thorax and the mediastinum in the lower region [3][4][5]. Our patient suffered from necrotizing fasciitis caused a necrosis, which spread to the submandibular region after an infected second lower molar tooth and finally progressed over a broad region of the neck.…”

Section: Discussionmentioning

confidence: 78%

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Life-Threatening Necrotizing Fasciitis of the Neck: A Case Report

Iynen

2011

J Curr Surg

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Necrotizing fasciitis is a rare, progressive and life-threatening bacterial infection which spreads with frightening speed along the fascial planes and subcutaneous tissue resulting in extensive tissue necrosis and often death. Rapidly spreading necrosis often causes systemic sepsis, toxic shock syndrome and multiorgan failure. Necrotizing fasciitis of the neck is rare and commonly has a dental or pharyngeal origin. Factors affecting the success of the treatment of necrotizing fasciitis are early diagnosis, appropriate antibiotics and surgical debridement. This article is presented in a patient with necrotizing fasciitis of the neck originated from odontogenic infection. Clinical features, pathogenesis and treatment of the case are discussed with the literature.

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Section: Discussionmentioning

confidence: 78%

“…The diagnosis can be made using a computerised tomography (CT) and subcutaneous gas formation. Treatment of the disease is early diagnosis, a careful aggressive debridement, parenteral antibiotic treatment, and supporting treatment controlling an underlying preparative, and aggravating factors [1,3].…”

Section: Introductionmentioning

confidence: 99%

Life-Threatening Necrotizing Fasciitis of the Neck: A Case Report

Iynen

2011

J Curr Surg

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“…The disease progresses faster in patients with diabetes, chronic kidney insuf iciency, immunocompromising diseases, patients with surgical traumas and patients undergoing radiation therapy. The diagnosis is based on clinical signs that initially can be hard to notice, that's why the diagnosis is set in the late stages of the disease, which results in comparatively high mortality [7][8][9][10][11]. In this case one of the major factors that had a role in the spreading of the infection was the infected cyst that was treated with antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2017

J Oral Health Craniofac Sci

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Necrotizing fasciitis is a quickly progressing soft tissue infection that can be described with diffuse necrosis of subcutaneous tissue and superfi cial fascia. The cause of this can be infectious process of odontogenic origin, most commonly caused by mixed gram+ and gram-, aerobic and anaerobic microorganisms that are found in patients that are predisposed to infections. In a case of undiagnosed illness, there is a possibility of life threatening complications. This case analysis introduces the diagnostic criteria of the disease and treatment plan, encouraging doctors to devote more attention to prevention of infections.

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“…1 Cervical necrotizing fasciitis (CNF) is a rare, rapidly advancing infection that involves the skin, the subcutaneous fibrofatty tissue, as well as the superficial and deep fascia and can cause life-threatening complications. 4,5 Widespread necrosis supplies a nutritious culture environment for bacterial growth. 2,3 The inflammatory process of NF is believed to be collagen necrosis caused by activated proteolytic enzyme, such as hyaluronidase from Streptococcus and proteases from anaerobic gram negative, in the superficial and deep fascial planes, which might relate to thrombosis, ischemia, and tissue necrosis.…”

mentioning

confidence: 99%

“…2,3 The inflammatory process of NF is believed to be collagen necrosis caused by activated proteolytic enzyme, such as hyaluronidase from Streptococcus and proteases from anaerobic gram negative, in the superficial and deep fascial planes, which might relate to thrombosis, ischemia, and tissue necrosis. 4 Up to last year, the patient with CNF was not seen in our clinic, but in the recent year, the 5 patients with CNF (2 of them were presented in the same journal) were admitted to our clinic. 6 The relative lack of vascularity of the relevant fascial planes has also been hypothesized as a contributing factor in NF.…”

mentioning

confidence: 99%

Facial Paralysis and Mediastinitis Due to Odontogenic Infection and Poor Prognosis

Bucak

Ulu²,

Kokulu³

et al. 2013

Journal of Craniofacial Surgery

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Cervical necrotizing fasciitis (CNF) is a rare, rapidly advancing infection that involves the skin, the subcutaneous fibrofatty tissue, as well as the superficial and deep fascia and can cause life-threatening complications. The most frequent initiating factors in the head and neck region are a primary odontogenic infection, a peritonsillar infection, as well as posttraumatic or iatrogenic skin and mucosal injuries. Necrotizing fasciitis (NF) can expand within hours, and the reported mortality rate is up to 75% with delay interference. If the patients have any risk factors, poor prognosis can be seen. In this study, 1 patient with CNF with a history of peritonsillar infection and 2 patients with CNF who had a history of odontogenic infection with spreading to the temporal region and the mediastinum were described, with information of the literature and a clinical experience that was gained from 5 patients with NF who were seen at our clinic in the recent year, despite the fact that CNF was not seen up to last year. None of the patients had any risk factors. One of them had a worse clinical state with ascending infection to the temporal region, cranial nerve paralysis, and descending necrotizing mediastinitis, but he recovered from NF. After the oral intake began, dyspnea due to aspiration was seen and he died because of sepsis and multiorgan dysfunction. We aimed to attract attention to the importance of dental pathologies and increased mortality in a healthy patient.

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Cervical necrotizing fasciitis and descending necrotizing mediastinitis in a patient affected by neglected peritonsillar abscess: A case of medical negligence

Cited by 18 publications

References 19 publications

Life-Threatening Necrotizing Fasciitis of the Neck: A Case Report

Life-Threatening Necrotizing Fasciitis of the Neck: A Case Report

Untitled

Facial Paralysis and Mediastinitis Due to Odontogenic Infection and Poor Prognosis

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