Abstract
Background: The aim of this report is to identify cases of cervicofascial necrotising fasciitis presenting to the Queen Elizabeth University Hospital Glasgow, over the course of 10 months. We reviewed and compared these cases to the literature in order to determine the optimal treatment provision. Methods: All patients admitted to our unit December 2017-October 2018 for cervicofascial necrotising fasciitis were identified. A retrospective data collection and analysis was carried out. Demographics, treatment provision and outcomes were examined for each patient. Results: A total of 5 patients were admitted to the Queen Elizabeth University Hospital for treatment of periorbital cervicofascial necrotising fasciitis in 10 months. All patients received urgent aggressive surgeries and empirical antibiotic therapies. All patients survived and went on to have facial reconstruction. Unfortunately, due to a delay in diagnosis, one patient required enucleation of their eye. Conclusions: Immediate surgical management as well as aggressive empirical antibiotic therapy remain the best treatment of cervicofascial necrotising fasciitis Timely diagnosis is of extreme importance to provide the best outcome for the patient. The Laboratory Risk Indicator for Necrotising Fasciitis score was utilised but did not produce consistently accurate results.
Highlights
Necrotising Fasciitis (NF) is an acute, life-threatening and rapidly spreading infection of the fascia
Of particular interest was their presentation, as two patients were initially admitted to Ear Nose and Throat (ENT) ward for treatment of periorbital cellulitis prior to being referred to the Oral and Maxillofacial Surgery (OMFS) team
Tissue necrosis may spread rapidly through superficial fascia and the subcutaneous fat layer, as well as through local nerves, arteries and veins [11].The bacterium closely related to NF is Streptococus pyogenes [2], which we have identified in all of the cases
Summary
Necrotising Fasciitis (NF) is an acute, life-threatening and rapidly spreading infection of the fascia. As only 200 cases have been published in the literature up to 2010 identifying cervicofacial necrotising fasciitis (CNF), the diagnosis of this life-threatening disease is difficult [3]. The aim of this report is to identify cases of cervicofascial necrotising fasciitis presenting to the Queen Elizabeth University Hospital Glasgow, over the course of 10 months. Methods: All patients admitted to our unit December 2017-October 2018 for cervicofascial necrotising fasciitis were identified. Results: A total of 5 patients were admitted to the Queen Elizabeth University Hospital for treatment of periorbital cervicofascial necrotising fasciitis in 10 months. Conclusions: Immediate surgical management as well as aggressive empirical antibiotic therapy remain the best treatment of cervicofascial necrotising fasciitis Timely diagnosis is of extreme importance to provide the best outcome for the patient. The Laboratory Risk Indicator for Necrotising Fasciitis score was utilised but did not produce consistently accurate results
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