[Life-threatening necrotizing fasciitis colli caused by Serratia marcescens].

Necrotizing fasciitis colli is a rare, but life-threatening disease. A 43-year-old female patient was admitted to our department because of increasing dysphagia and slight swelling of the left side of her neck due to severe necrotizing pharyngolaryngitis. Initial treatment with cephalosporin I was ineffective. The patient developed a rapidly spreading necrotizing fasciitis of the neck requiring open surgery for débridement and drainage as well as tracheostomy. Microbiological analysis revealed Serratia marcescens, thus allowing targeted and ultimately successful antibiotic therapy. The case shows that even saprophytes like Serratia marcescens may cause a necrotizing fasciitis. Therefore, the initially calculated antibiotic treatment should include a wide spectrum of aerobic and anaerobic germs.