Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2021, Vol. 35 ›› Issue (4): 12-16.doi: 10.6040/j.issn.1673-3770.0.2020.403

Previous Articles     Next Articles

Three cases of diagnosis and treatment of cervical necrotizing fasciitis with a primary diagnosis of acute epiglottitis

ZHAO Yaming, SHI Song   

  1. Department of Otolaryngology, Tong Ren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
  • Published:2021-08-05

PDF (PC)

203

Abstract: Objective To investigate the relationship between acute epiglottitis and cervical necrotizing fasciitis and its’ clinical course. Methods A retrospective analysis of the clinical data of 3 cases of cervical necrotizing fasciitis with acute epiglottitis as the primary diagnosis. The correlation, diagnosis, and treatment of acute epiglottitisand cervical necrotizing fasciitis were analyzed. Results Three patients underwentsurgery after a definite diagnosis by neck CT.(1fatality and 2recoveries). Conclusion The possibility of cervical necrotizing fasciitis should be considered inpatients with acute epiglottitis who fail to respond to active anti-infective and anti-inflammatory treatment. Early surgery, drainage, and vigilance regarding the basic treatment of systemic diseases are keys to the treatment of cervical necrotizing fasciitis.

Key words: Acute epiglottitis, Cervical necrotizing fasciitis, Surgery, Infection, Complications

CLC Number: 

  • R686
[1] Paz Maya S, Dualde Beltrán D, Lemercier P, et al. Necrotizing fasciitis: an urgent diagnosis[J]. Skeletal Radiol, 2014, 43(5): 577-589. doi:10.1007/s00256-013-1813-2.
[2] Iacopi E, Coppelli A, Goretti C, et al. Necrotizing fasciitis and the diabetic foot[J]. Theinternational journal of lower extremity wounds, 2015, 14(4): 316-327. doi: 10.1177/1534734615606534.
[3] Nisbet M, Ansell G, Lang S, et al. Necrotizing fasciitis: review of 82 cases in South Auckland[J]. Intern Med J, 2011, 41(7): 543-548. doi:10.1111/j.1445-5994.2009.02137.x.
[4] (·overI)smi O, Ye??塂ilova M, Özcan C, et al. Difficult cases of odontogenic deep neck infections: a report of three patients[J]. Balkan Med J, 2017, 34(2): 172-179. doi:10.4274/balkanmedj.2015.1379.
[5] 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.
[6] Smith JL II, Hsu JM, Chang J. Predicting deep neck space abscess using computed tomography[J]. Am J Otolaryngol, 2006, 27(4): 244-247. doi:10.1016/j.amjoto.2005.11.008.
[7] 展影, 夏爽, 祁吉. 颈深筋膜间隙感染的影像学诊断[J]. 实用放射学杂志, 2010, 26(6): 800-804. doi:10.3969/j.issn.1002-1671.2010.06.008. ZHAN Ying, XIA Shuang, QI Ji. Imaging diagnosis in deep fascial space infections of neck[J]. Journal of Practical Radiology, 2010, 26(6): 800-804. doi:10.3969/j.issn.1002-1671.2010.06.008.
[8] Sarna T, Sengupta T, Miloro M, et al. Cervical necrotizing fasciitis with descending mediastinitis: literature review and case report[J]. J Oral Maxillofac Surg, 2012, 70(6): 1342-1350. doi:10.1016/j.joms.2011.05.007.
[9] Estrera AS, Landay MJ, Grisham JM, et al. Descending necrotizing mediastinitis[J]. Surg Gynecol Obstet, 1983, 157(6): 545-552. doi: 10.2298/VSP0607677C.
[10] 姜青云,李鸿,夏纪严.颈部坏死性筋膜炎并粒细胞减少一例报告[J].山东大学耳鼻喉眼学报,2018,32(6):114-116.doi: 10.6040 /j.issn.1673-3770.0.2017.490
[11] Huang TT, Tseng FY, Liu TC, et al. Deep neck infection in diabetic patients: Comparison of clinical picture and outcomes with nondiabetic patients[J]. Otolaryngol-Head Neck Surg, 2005, 132(6): 943-947. doi:10.1016/j.otohns.2005.01.035.
[12] 周兰柱, 周恩晖, 刘素茹, 等. 颈部坏死性筋膜炎的临床特点及处理策略[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(6): 545-548. doi:10.13201/j.issn.1001-1781.2019.06.017. ZHOU Lanzhu, ZHOU Enhui, LIU Suru, et al. Clinical characteristics and management of cervical necrotizing fasciitis[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, 33(6): 545-548. doi:10.13201/j.issn.1001-1781.2019.06.017.
[13] 宋秋萍. 某院2018年118例糖尿病伴感染患者临床治疗中抗菌药物使用情况分析[J]. 抗感染药学, 2019, 16(12): 2078-2082. doi:10.13493/j.issn.1672-7878.2019.12-013.
[14] 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.
[15] 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.
[16] 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.
[17] 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.
[18] 中华医学会呼吸病学分会感染学组. 中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南(2018年版)[J]. 中华结核和呼吸杂志, 2018, 41(4): 255-280. doi:10.3760/cma.j.issn.1001-0939.2018.04.006.
[1] 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.
[2] WANG Huan, HU Li,YU Hongmeng. Research progress of olfactory dysfunction in chronic rhinosinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 43-49.
[3] CAO Xuan,XIAO Xuping, LI Yunqiu. Advances in the application of hyaluronic acid in chronic sinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 104-109.
[4] QIN Ming, SUN Zhanwei, WANG Weiwei, LI Shichao, WU Tianyi, WANG Guangke. Efficacy of alkaline isotonic saline in laryngopharyngeal reflux symptom-positive or finding score-positive patients with chronic rhinosinusitis following endoscopic sinus surgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 147-153.
[5] CHEN Shiqin, WEI Pingcun, HU Yunlong, HU Jinwang. Effects of three different nasal uses of glucocorticoid on mucosal outcome after endoscopic sinus surgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 195-201.
[6] ZHAO Xiaobing,ZHANG Dawei, CHEN Renjie. A case of middle-ear anaplastic large T- cell lymphoma and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 7-14.
[7] 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.
[8] DANG Panhong, ZHANG Rui, HU Chunyan, WANG Jie, FAN Mengyun. Clinical analysis of facial nerve decompression via an external transmastoid-subtemporal labyrinth approach in eight children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 37-42.
[9] CHEN Kun, LU Hui, HUANG Qi, LI Lei, MENG Guozhen, YANG Jun, HOU Dongming. Clinical diagnosis and treatment of congenital nasal sinus mass in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 81-85.
[10] ZENG Bin, LÜ Dan, REN Jia, HU Juanjuan, YU Lingyu, LU Huan, YANG Hui. Application of laryngeal microsurgery in severe neonatal upper airway obstruction [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 95-99.
[11] LI Ying. Importance of standardized methods in corneal refractive surgery and the prevention of complications [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 1-6.
[12] WANG Lixiang,LI Ying, DENG Yingping. The application of corneal stromal lenticules extracted from small incision lenticule extraction surgery for hyperopia correction [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 7-12.
[13] CIREN Qiongda, WU Yuan. A case of long-term ocular complications caused by toxic epidermal necrolysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 147-150.
[14] QIN He, WAN Baogang, WANG Hongli, ZHAO Benqi. Computed tomography-based preoperative diagnosis of fungal ball sinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 32-35.
[15] BA Guangyi, MAO Song, SUN Xiwen, TANG Ru, LI Zhipeng, LIN Hai, ZHANG Weitian. Application of Voxel-man ENT surgery simulation system in the training of nasal operation technique [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 56-61.
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 .
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd