Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (6): 135-138.doi: 10.6040/j.issn.1673-3770.0.2020.072

Previous Articles    

Progress in the clinical diagnosis and treatment of cervical necrotizing fasciitis

YUAN KanglongOverview,XIAO XupingGuidance   

  1. Department of Otolaryngology & Head and Neck Surgery, the First Affiliated Hospital of Hunan Normal University/Hunan Provincial People's Hospital, Changsha 410005, Hunan, Chian
  • Published:2021-01-11

Abstract: Cervical necrotizing fasciitis(CNF)is a severe soft tissue inflammation of the neck caused by mixed bacterial infections. It is characterized by necrosis of neck subcutaneous tissue with deep and shallow fasciitis. Elderly individuals and those with chronic comorbid diseases(such as diabetes)are more susceptible to CNF. The early clinical diagnosis rate is lowand the disease progresses rapidly. Life-threatening complications are such as descending necrotizing mediastinitisand septic shock are frequently observed. The mortality rate is extremely high. This article reviews the clinical diagnosis and treatment of CNF to facilitate early diagnosis and treatment.

Key words: Fasciitis, Necrotizing, Neck, Diagnosis, Treatment

CLC Number: 

  • R686
[1] Kulasegaran S, Cribb B, Vandal AC, et al. Necrotizing fasciitis: 11-year retrospective case review in South Auckland[J]. ANZ J Surg, 2016, 86(10): 826-830. doi:10.1111/ans.13232.
[2] Elander J, Nekludov M, Larsson A, et al. Cervical necrotizing fasciitis: descriptive, retrospective analysis of 59 cases treated at a single center[J]. Eur Arch Otorhinolaryngol, 2016, 273(12): 4461-4467. doi:10.1007/s00405-016-4126-y.
[3] Gausepohl J, Wagner J. Survival from cervical necrotizing fasciitis[J]. West J Emerg Med, 2015, 16(1): 172-174. doi:10.5811/westjem.2014.12.21553.
[4] Adekanye AG, Umana AN, Offiong ME, et al. Cervical necrotizing fasciitis: management challenges in poor resource environment[J]. Eur Arch Otorhinolaryngol, 2016, 273(9): 2779-2784. doi:10.1007/s00405-015-3841-0.
[5] Ferzli G, Sukato DC, Mourad M, et al. Aggressive necrotizing fasciitis of the head and neck resulting in massive defects[J]. Ear Nose Throat J, 2019, 98(4): 197-200. doi:10.1177/0145561319839789.
[6] Al-Ali MA, Hefny AF, Idris KM, et al. Cervical necrotizing fasciitis: an overlooked diagnosis of a fatal disease[J]. Acta Otolaryngol, 2018, 138(4): 411-414. doi:10.1080/00016489.2017.1393841.
[7] Abdurrazaq TO, Ibikunle AA, Braimah RO. Cervical necrotizing fasciitis: a potentially fatal disease with varied etiology[J]. Ann Med Health Sci Res, 2016, 6(4): 251-256. doi:10.4103/amhsr.amhsr_33_16.
[8] Ly AT, Noto JP, Walwyn OL, et al. Differences in SpeB protease activity among group A streptococci associated with superficial, invasive, and autoimmune disease[J]. PLoS One, 2017, 12(5): e0177784. doi:10.1371/journal.pone.0177784.
[9] Wen YT, Wang JS, Tsai SH, et al. Label-free proteomic analysis of environmental acidification-influenced Streptococcuspyogenessecretome reveals a novel acid-induced protein histidine triad protein A(HtpA)involved in necrotizing fasciitis[J]. J Proteomics, 2014, 109: 90-103. doi:10.1016/j.jprot.2014.06.026.
[10] Nougué H, Le Maho AL, Boudiaf M, et al. Clinical and imaging factors associated with severe complications of cervical necrotizing fasciitis[J]. Intensive Care Med, 2015, 41(7): 1256-1263. doi:10.1007/s00134-015-3830-1.
[11] 赵雅铭, 易红良, 关建, 等. 29例颈部坏死性筋膜炎临床分析[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(7): 490-492. doi:10.13201/j.issn.1001-1781.2014.07.017. ZHAO Yaming, YI Hongliang, GUAN Jian, et al. Clinical analysis of 29 cases of cervical necrotizing fasciitis[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2014, 28(7): 490-492. doi:10.13201/j.issn.1001-1781.2014.07.017.
[12] Goh T, Goh LG, Ang CH, et al. Early diagnosis of necrotizing fasciitis[J]. Br J Surg, 2014, 101(1): e119-e125. doi:10.1002/bjs.9371.
[13] Emmanuel Kofi Amponsah, Paul Frimpong, Mi Young Eo, et al. Clinical classification of cervical necrotizing fasciitis[J]. Eur Arch Otorhinolaryngol, 2018, 275(12): 3067-3073. doi:10.1007/s00405-018-5155-5.
[14] Sandner A, Moritz S, Unverzagt S, et al. Cervical necrotizing fasciitis: the value of the laboratory risk Indicator for necrotizing fasciitis score as an indicative parameter[J]. J Oral Maxillofac Surg, 2015, 73(12): 2319-2333. doi:10.1016/j.joms.2015.05.035.
[15] 肖恩华. 坏死性筋膜炎临床和影像学表现[J]. 临床放射学杂志, 2002, 21(5): 400-402. doi:10.13437/j.cnki.jcr.2002.05.030.
[16] 陈伟军, 胡建文, 腾陈迪. 面颈部坏死性筋膜炎的诊治[J]. 中国耳鼻咽喉头颈外科, 2010, 17(3): 153-154. doi:10.16066/j.1672-7002.2010.03.024.
[17] Shyy W, Knight RS, Goldstein R, et al. Sonographic findings in necrotizing fasciitis[J]. J Ultrasound Med, 2016, 35(10): 2273-2277. doi:10.7863/ultra.15.12068.
[18] Wong CH, Khin LW, Heng KS, et al. The LRINEC(Laboratory Risk Indicator for Necrotizing Fasciitis)score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections[J]. Crit Care Med, 2004, 32(7): 1535-1541. doi:10.1097/01.ccm.0000129486.35458.7d.
[19] Kato T, Fujimoto N, Honda S, et al. Usefulness of serum procalcitonin for early discrimination between necrotizing fasciitis and cellulitis[J]. Acta DermVenereol, 2017, 97(1): 141-142. doi:10.2340/00015555-2465.
[20] Hayeri MR, Ziai, Shehata ML, et al. Soft-tissue infections and their imaging mimics: from cellulitis to necrotizing fasciitis[J]. Radiographics, 2016, 36(6): 1888-1910. doi:10.1148/rg.2016160068.
[21] Javier Moraga, Mauricio Chang, María Rodríguez. Atypical presentation of cervical necrotizing fasciitis. Case report[J]. Journal of Oral Research, 2017, 6(7):182-185. doi:10.17126/joralres.2017.052.
[22] Muniraja P, Kavitha K, Aneesh, et al. The role of empirical antibiotic therapy in treating necrotizing fasciitis: aretrospective record analysis[J]. International Journal of Contemporary Medical Research, 2016, 3(5):1481-1484.
[23] Petitpas F, Blancal JP, Mateo J, et al. Factors associated with the mediastinal spread of cervical necrotizing fasciitis[J]. Ann Thorac Surg, 2012, 93(1): 234-238. doi:10.1016/j.athoracsur.2011.09.012.
[24] Inan CH, Yener HM, Yilmaz M, et al. Cervical necrotizing fasciitis of odontogenic origin and hyperbaric oxygen therapy[J]. J Craniofac Surg, 2017, 28(7): e691-e692. doi:10.1097/SCS.0000000000003842.
[25] 陈秀梅,宋西成. 颈部坏死性筋膜炎7例并文献复习[J].山东大学耳鼻喉眼学报, 2016, 30(3): 65-67,72. doi:10.6040/j.issn.1673-3770.0.2015.305. CHEN Xiumei, SONG Xicheng, Diagnosis and treatment of cervical necrotizing fasciitis: a report of 7 cases and literature review[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2016, 30(3): 65-67,72. doi:10.6040/j.issn.1673-3770.0.2015.305.
[26] Frankel JK, Rezaee RP, Harvey DJ, et al. Use of negative pressure wound therapy with instillation in the management of cervical necrotizing fasciitis[J]. Head Neck, 2015, 37(11): E157-E160. doi:10.1002/hed.24028.
[27] Juncar M, Bran S, Juncar RI, et al. Odontogenic cervical necrotizing fasciitis, etiological aspects[J]. Niger J Clin Pract, 2016, 19(3): 391-396. doi:10.4103/1119-3077.179278.
[28] Tarnutzer A, Andreoni F, Keller N, et al. Human polyspecific immunoglobulin attenuates group A streptococcal virulence factor activity and reduces disease severity in a murine necrotizing fasciitis model[J]. Clin Microbiol Infect, 2019, 25(4): 512.e7-512.e13. doi:10.1016/j.cmi.2018.07.007.
[29] Gunaratne DA, Tseros EA, Hasan Z, et al. Cervical necrotizing fasciitis: Systematic review and analysis of 1235 reported cases from the literature[J]. Head Neck, 2018, 40(9): 2094-2102. doi:10.1002/hed.25184.
[1] ZHANG YuOverview,QU YiGuidance. Research progress on the pathogenesis and control of ocular toxoplasmosis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 70-76.
[2] SONG QingOverview,SONG XichengGuidance. Research progress of anlotinib combination therapy in cancer treatment [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 106-112.
[3] HUANG Yangzhou, FU Lihua, WU Qiaolian, HUANG Xia, LIN Jun, YE Qing. Misdiagnosis of nodular fasciitis of mastoid process: a case report [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 119-121.
[4] ZHANG Keren, LEI Chunyan, ZHANG Meixia. Floppy eyelid syndrome associated with obstructive sleep apnea: a case report [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 125-128.
[5] TIAN Jun, LIU Liangfa, BAI Jiaqi. Cervical vertebral osteomyelitis secondary to necrotizing otitis externa:a case report and review of literature [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 1-5.
[6] ZHANG Lijun, XU Ran, LUO Jifang, LIU Guoqi, HE Qian, LI Wei, JIANG Zhenhua. Factors affecting flap neurosis and other postoperative flap-related complications after free-flap reconstruction of head and neck tumors [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 86-90.
[7] SHI Anni, ZHANG Jiajia, BAI Peng, ZHANG Chongyang. Analysis of a therapeutic modality for sudden deafness utilizing neck acupuncture comprising seven lines of treatment [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 103-107.
[8] CHENG Lei, XU Qiuyan, CHEN Hao. Clinical use and significance of allergy testing and diagnostics [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 1-6.
[9] XIONG Panhui, SHEN Yang,YANG Yucheng. Advancements in the diagnosis and treatment of chronic sinusitis based on phenotypes and endotypes [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 15-19.
[10] LIANG Xu,SHI Li. Research progress in biologic targeted drug therapy for chronic sinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 30-35.
[11] GU Yu, WAN Xin,XIAO Zi'an. The interaction between neutrophils and eosinophils in chronic rhinosinusitis and the implications on treatment options [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 56-63.
[12] ZENG Xianting, WANG Guangke, SUN Zhanwei, WU Tianyi, LI Shichao, WANG Weiwei. Postoperative efficacy of proton pump inhibitor in the treatment of difficult-to-treat rhinosinusitis with laryngopharyngeal reflux [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 189-194.
[13] FENG Yiyuan, YANG Jing, YANG Hongbin. Clinical analysis of 220 cases of deep neck space infection [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 51-57.
[14] ZHANG Taoran, WANG Wei, LI Mingming, HUANG Yingxiang. Subfoveal choroidal thickness changes following intravitreal ranibizumab treatment in choroidal neovascularization due to pathological myopia [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 68-71.
[15] HUA Hongli, LI Song,TAO Zezhang. Research progress of artificial intelligence in the diagnosis and treatment of nasopharyngeal carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 113-119.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 84 -87 .
[2] NIU Shanli,CHAI Maowen,LI Zhenxiu . Endoscopic rhinoplasty of inferior turbinate in 60 patients with chronic hypertrophic rhinitis[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 16 -18 .
[3] MENG Qing-guo,LU Yong-tian,FAN Xian-liang .

Association of killer cell immunoglobulin-like receptor gene polymorphisms with nasopharyngeal carcinoma

[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 196 -199 .
[4] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 199 -199 .
[5] WAN Li-jia,LU Hai-tao,JIANG Yi-dao,LIU Hui,LI Qin,SHE La-zhi . Effect of H-uvulopalatopharyngoplasty on obstructive sleep apnea
hypopnea syndrome
[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 204 -205 .
[6] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 222 -224 .
[7] JI Xiao-bin,DENG Jia-de,ZANG Lin-quan,WANG Lei,XIE Jun . Blood histamine in guinea pigs with allergic rhinitis[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 228 -230 .
[8] XIANG Deng,LU Yong-tian,SUN Huan-ji . Endoscopic repair for cerebrospinal fluid rhinorrhea in 19 cases and a literature review [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 234 -236 .
[9] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 253 -257 .
[10]
YIN Guo-hua,ZHONG Xiao . Long-term effect of laser reduction on lingua adenoids
[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 280 -282 .