Document Detail

Peritonsillar abscess: an unlikely cause of necrotizing fasciitis.
MedLine Citation:
PMID:  7857015     Owner:  NLM     Status:  MEDLINE    
Cervical necrotizing fasciitis is a devastating polymicrobial soft tissue infection characterized by gas formation and extensive necrosis of subcutaneous fat and fascia with extension to skin and muscle. Involvement of the head and neck is rare and is typically dental in origin. Despite broad-spectrum antibiotics, mortality rates for this disease remain high. We report a successfully treated case of necrotizing fasciitis arising from a peritonsillar abscess. Review of the literature reveals only 6 other cases, with 3 successful outcomes. Early diagnosis, broad-spectrum antibiotics, and aggressive surgical debridement are the cornerstones of therapy. The pathophysiology is typically a mixed aerobic and anaerobic infection. Supportive treatment options such as hyperbaric oxygen therapy and high-calorie supplemental nutrition may be of benefit. A comprehensive literature review of craniocervical necrotizing fasciitis is presented. Factors associated with poor outcomes include diabetes mellitus, mediastinitis, cardiovascular disease, and peritonsillar abscess.
J H Greinwald; J F Wilson; P G Haggerty
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Annals of otology, rhinology, and laryngology     Volume:  104     ISSN:  0003-4894     ISO Abbreviation:  Ann. Otol. Rhinol. Laryngol.     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-03-14     Completed Date:  1995-03-14     Revised Date:  2006-05-15    
Medline Journal Info:
Nlm Unique ID:  0407300     Medline TA:  Ann Otol Rhinol Laryngol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  133-7     Citation Subset:  AIM; IM    
Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center, Portsmouth, Virginia.
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MeSH Terms
Combined Modality Therapy
Drug Therapy, Combination
Fasciitis / etiology*,  therapy
Peritonsillar Abscess / complications*,  microbiology,  therapy
Streptococcal Infections / complications*,  microbiology,  therapy
Streptococcus pyogenes / isolation & purification

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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