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Necrotizing fasciitis after peritonsillar abscess in an immunocompetent patient

Published online by Cambridge University Press:  29 June 2007

Neven Skitarelić ,
Ranko Mladina ,
Zlatko Matulić  and
Maruan Kovačić
Neven Skitarelić*
Affiliation:
Department Otolaryngology – Head and Neck Surgery, General Hospital, Zadar, Croatia
Ranko Mladina
Affiliation:
ORL Clinic, University Hospital Šalata, Zagreb, Croatia
Zlatko Matulić
Affiliation:
Department Otolaryngology – Head and Neck Surgery, General Hospital, Zadar, Croatia
Maruan Kovačić
Affiliation:
Department Otolaryngology – Head and Neck Surgery, General Hospital, Zadar, Croatia
*
Address for correspondence: Dr N. Skitarelić, Siroka ulica 9 A, 23 000 Zadar, Croatia.
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Abstract

Cervical necrotizing fasciitis (CNF) is a rapidly progressive, severe bacterial infection of the fascial planes of the head and neck. Group A beta haemolytic Streptococcus spp. (GABHS), Staphylococcus spp., or obligatory anaerobic bacteria are the most common causative pathogens. The disease usually results from a dental source or facial trauma. Extensive fascial necrosis and severe systemic toxicity are common manifestations of CNF. Review of the literature reveals only seven such cases, with four successful outcomes.

The authors present the case of a 50-year-old immunocompetent female with CNF arising from a peritonsillar abscess. Intravenous immunoglobulins in conjunction with surgery and antibotics were used successfully.

The authors also suggest the importance of the early diagnosis, aggressive surgical debridement, broadspectrum antibiotics, and possible usefulness of the intravenous immunoglobulins in the treatment of CNF, especially when the disease is associated with toxic shock syndrome.

Keywords

Fasciitis, necrotizingImmunoglobulins, intravenous
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 8 , August 1999 , pp. 759 - 761
Copyright
Copyright © JLO (1984) Limited 1999

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