I Mohammedi1, P Ceruse, S Duperret, J Vedrinne, P Boulétreau. 1. Department of Intensive Care and Hyperbaric Medicine, Pavillon N, Edouard Herriot Hospital, Place d'Arsonval, F-69 003 Lyon, France. ismael.mohammedi@chu-lyon.fr
Abstract
OBJECTIVE: To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution. DESIGN: Retrospective clinical investigation. PATIENTS AND METHODS: We reviewed the charts of 20 consecutive patients hospitalized in our Intensive Care Unit between January 1987 and June 1998 with the diagnosis of cervical necrotizing fasciitis. RESULTS: All the patients required mechanical ventilation. Four of them had mediastinal involvement. The organisms most commonly implicated included Streptococcus, Prevotella, and Peptostreptococcus species. Patients with adequate surgery had a better outcome than those with inadequate surgical procedures. Because no evidence-based recommendations exist in the field of head and neck infections, hyperbaric oxygen was not used as adjunctive therapy. Of the 20 patients, 3 (15 %) died. CONCLUSION: The main finding of this study is that prompt, rather than delayed, surgical débridement correlates with a decrease in morbidity and mortality. However, no definite conclusion is justified due to the relatively small number of patients. Immediate radical débridement, and early redébridement if needed, appropriate antibiotics and intensive care support are critical in controlling these life-threatening infections.
OBJECTIVE: To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution. DESIGN: Retrospective clinical investigation. PATIENTS AND METHODS: We reviewed the charts of 20 consecutive patients hospitalized in our Intensive Care Unit between January 1987 and June 1998 with the diagnosis of cervical necrotizing fasciitis. RESULTS: All the patients required mechanical ventilation. Four of them had mediastinal involvement. The organisms most commonly implicated included Streptococcus, Prevotella, and Peptostreptococcus species. Patients with adequate surgery had a better outcome than those with inadequate surgical procedures. Because no evidence-based recommendations exist in the field of head and neck infections, hyperbaric oxygen was not used as adjunctive therapy. Of the 20 patients, 3 (15 %) died. CONCLUSION: The main finding of this study is that prompt, rather than delayed, surgical débridement correlates with a decrease in morbidity and mortality. However, no definite conclusion is justified due to the relatively small number of patients. Immediate radical débridement, and early redébridement if needed, appropriate antibiotics and intensive care support are critical in controlling these life-threatening infections.
Authors: Chai R Soh; Ricardo Pietrobon; John J Freiberger; Sophia T Chew; Dimple Rajgor; Mihir Gandhi; Jatin Shah; Richard E Moon Journal: Intensive Care Med Date: 2012-04-20 Impact factor: 17.440
Authors: Alessio Danilo Inchingolo; Sabino Ceci; Luisa Limongelli; Alberto Corriero; Luigi Curatoli; Daniela Azzollini; Pietro Paolo Mezzapesa; Grazia Marinelli; Giuseppina Malcangi; Giovanni Coloccia; Mario Ribezzi; Maria Massaro; Ioana Roxana Bordea; Antonio Scarano; Felice Lorusso; Nicola Brienza; Gianfranco Favia; Nicola Quaranta; Francesco Inchingolo Journal: Case Rep Dent Date: 2022-07-12
Authors: V Fihman; L Raskine; F Petitpas; J Mateo; R Kania; J Gravisse; M Resche-Rigon; I Farhat; B Berçot; D Payen; M J Sanson-Le Pors; P Herman; A Mebazaa Journal: Eur J Clin Microbiol Infect Dis Date: 2008-03-04 Impact factor: 3.267