• Ear Nose Throat J · Aug 2004

    Case Reports

    Craniocervical necrotizing fasciitis of odontogenic origin with mediastinal extension.

    • John D Edwards, Nader Sadeghi, Farzad Najam, and Mark Margolis.
    • Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, George Washington University Medical Center, Washington, DC 20037, USA. jde@gwu.edu
    • Ear Nose Throat J. 2004 Aug 1; 83 (8): 579-82.

    AbstractWe review an interesting case of craniocervical necrotizing fasciitis with thoracic extension in an immunocompetent 44-year-old man. The patient underwent aggressive medical and surgical management during a long hospitalization. Multiple surgical debridements, including transcervical mediastinal debridement, and eventually a thoracotomy for mediastinal abscess were required. The patient eventually recovered, and 3 months later he showed no sign of complications or recurrence. Craniocervical necrotizing fasciitis is a fulminant soft-tissue infection, usually of odontogenic origin, that requires prompt identification and treatment to ensure survival. Broad-spectrum intravenous antibiotics, aggressive surgical debridement and wound care, hyperbaric oxygen, and good intensive care are the mainstays of treatment.

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