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Novel management of cervical necrotising fasciitis in a developing country: case report

Published online by Cambridge University Press:  12 October 2010

A Salisu ,
A A Adeosun ,
N H Emma-Nzekwue  and
S B Abubakar
A Salisu*
Affiliation:
Department of ENT, University College Hospital, Ibadan, Nigeria
A A Adeosun
Affiliation:
Department of ENT, University College Hospital, Ibadan, Nigeria
N H Emma-Nzekwue
Affiliation:
Department of ENT, University College Hospital, Ibadan, Nigeria
S B Abubakar
Affiliation:
Department of Microbiology, University College Hospital, Ibadan, Nigeria
*
Address for correspondence: Dr A Salisu, Consultant ENT Surgeon, Federal Medical Centre, Gusau, Zamfara State, Nigeria E-mail: [email protected]
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Abstract

Objective:

We report a rare case of cervical necrotising fasciitis arising from poorly managed acute tonsillitis.

Case report:

A 23-year-old woman presented with a two-week history of fever and an eight-day history of painful neck swelling. Nine days before presentation, she had received digital manipulation of her throat by a neighbour, which had worsened her throat pain. There was associated progressive generalised neck swelling, odynophagia, dysphagia and dyspnoea. An X-ray of the neck soft tissue showed multiple gas collections.

Conclusion:

Cervical necrotising fasciitis is rare and usually odontogenic in origin. It is associated with a high mortality rate. Our patient responded to aggressive daily bedside wound debridements and dressings, appropriate intravenous antibiotics and high-protein nutritional support. In this way, exploration under general anaesthesia was avoided, in a developing country with limited facilities.

Keywords

CervicalNecrotizing FasciitisAcute TonsillitisConscious SedationDebridementNecrotic Neck Wound
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 1 , January 2011 , pp. 93 - 95
Copyright
Copyright © JLO (1984) Limited 2010

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