LIFE-THREATENING CERVICAL NECROTIZING FASCIITIS

Eight cases of cervical necrotizing fasciitis are presented. Three wer e odontogenic, two were pharyngeal in origin and three were primary or idiopathic. Soft tissue gas was recognized in four patients. The bact eriology showed streptococci on the top of the list (50%), while for t he idiopathic cases, it was monomicrobial and caused by staphylococci. Third generation cephalosporin and metronidazole represent good initi al empirical antibacterial coverage. Histopathologically, all cases sh owed extensive necrosis of the debrided fascia and vascular thrombosis of tile dermal vessels. The mortality rate was 3/8 (37.5%). Early dia gnosis of cervical necrotizing fasciitis and initiation of definitive therapy in an intensive care environment is essential to minimize mort ality. It is also important to recognize that this devastating infecti on may occur spontaneously, and it should be suspected in patients wit h unexplained soft tissue pain and tenderness.