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] LIU Jiahui, TIAN Ruxian, LI Yumei, SONG Xicheng. Construct of a cuproptosis-related lncRNA model to predict prognosis in head and neck squamous cell carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(2): 49-64.
[2] ZHU Mingqiong, LI Zheng, LIU Ru, TIAN Tao, PENG Jingli, LYU Qianyi, TAN Huaxia. The application of AI screening system based on OCT/OCTA in the evaluation of the effect of anti VEGF treatment in patients with diabetes macular edema [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 68-73.
[3] LU Zhaoyang, ZHAI Zhaoxue, WANG Huikang, SHAO Liting, ZHANG Yu. COVID-19 treatment-induced diabetic ketoacidosis combined with rhino-orbital cerebral mucormycosis: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 90-94.
[4] CHENG Zhuo, LIANG Hui, XING Lumin. Research progress and prospect analysis of deep learning technology in the application of pharyngeal and laryngeal endoscopy [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 112-119.
[5] LIU Yijie, LU Xiuzhen, WU Qiuxin. Research rogress of exosomes in the pathogenesis, diagnosis and treatment in ophthalmic diseases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 135-141.
[6] LI Zan, LU Qi, SHEN Weidong, HOU Zhaohui, WU Nan. Clinical diagnosis and treatment features of 18 cases of necrotizing otitis externa [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 17-22.
[7] MA Xiaobao, SHEN Jiali, YANG Jun, CHEN Jianyong, ZHU Songhuan. Exploring the clinical implications of normal VOR gain with refixation saccades in lateral canal [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 40-45.
[8] LIU Ziqi, HUANG Jiali, WANG Liqin, CHEN Xi, ZHANG Liqing, ZHOU Han. Application of narrow band imaging endoscopy combined with voice acoustic analysis in the differential diagnosis of vocal cord leukoplakia [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 87-96.
[9] PAN Linlin, WAN Jiaming, LI Yue, HE Long. Autophagy-related long noncoding RNA is a prognostic indicator for head and neck squamous cell carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 97-107.
[10] LIU Yuzhu, CHEN Yao, YUAN Tiejun, LI Chunsen, LI Bo. Larynx fibrosarcoma: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 133-137.
[11] SUN Shuo, YUAN Tiejun, CHEN Yao, QI Lingling, HAN Rongrong. Misdiagnosis of lingual tuberculosis: a case report and literature veview [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 138-143.
[12] LIU Nanxian, YANG Zeyin, HAN Lin, ZHANG Aiying, ZHAO Yuliang, XUE Jing, SUN Yijun, SHAO Yongliang. Significance of video-EEG in the diagnosis of recurrent vertigo in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 20-25.
[13] YIN Zhenqian, HUANGFU Hui. Kimura disease:a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 104-107.
[14] GU Zhanxin, ZHAO Zhouyang, ZHANG Xiaobin, YANG Yimei, HUANG Lijin, HUANG Yan. Syndrome differentiation treatment and understanding of traditional Chinese medicine in carotid blowout syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 100-107.
[15] SHI Jinlian, LI Jianxing, HUANG Yousheng, LIN Mingxuan, LIU Lingyun, LU Yongtian. Research status and progress in diagnosis and treatment of laryngeal inflammatory myofibroblastic tumor [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 186-192.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!