Necrotising fasciitis of the head and neck

Introduction: Necrotising fasciitis is still a severe disease whose outcome is occasionally fatal. Methods: Between August 1994 and August 1998, 6 patients with necrotising f asciitis, 5 in the neck area and one in the facial area, were treated. The source of the infection was odontogenic in 3 cases, pharyngeal in 3 and an insect sting in the left upper eyelid in one case. Results: Following evaluation by CT scan, immediate surgical exploration wi th debridement and drainage was performed. Revision proved necessary in mos t cases. One patient suffered severe complications. Median stay in the inte nsive care unit was 7 days and in hospital 20 days. Discussion: Deep and extensive neck infections require investigation by CT scan. All affected areas must be explored and drained immediately, includin g thoracotomy if mediastinitis is present. Apart from appropriate antibioti c therapy, the further course of the disease should he carefully monitored to detect further spread of the infection as well as complications.