Necrotizing fasciitis: A five years review of cases seen at the Lagos University Teaching Hospital
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Date
2019-10-09
Authors
James, O.
Anorue, E.I.
Adamson, O.O.
Adeyemi, M.O.
Adekunle, A.A.
Ladeinde, A.L.
Ogunlewe, M.O.
Adeyemo, W.L.
Journal Title
Journal ISSN
Volume Title
Publisher
FDS, CMUL 2019
Abstract
Background: Cranio-facial necrotizing (CFN) fasciitis of the head and neck is a bacterial infection characterized by spreading along fascia planes and subcutaneous tissue. This results in tissue necrosis and may lead to death. It is commonly triggered by odontogenic or pharyngeal infections.
Aim: To retrospectively review cases seen in our center to determine the factors that might affect the outcome
Patient and methods: This was a five years retrospective study of patients presenting with necrotizing fasciitis, treated at the Department of Oral and Maxillofacial Surgery, LUTH from 2014 to 2018. The medical records were reviewed for: aetiology, trigger factors and sites of infection, clinical manifestations, underlying medical condition, type of surgical treatment, medical and surgical complications, length of hospital stay and outcome of treatment.
Results: Twenty –three patients with head and neck necrotizing fasciitis were treated during the study period. There were 11 males and 12 females in this group. The average age was 43 years, with age range between 22 and 84 years. Triger factor in most cases was odontogenic infection (18, 78.3%) while the upper part of the neck was the most prevalent site of presentation. Clinical presentations were a rapidly progressing painful neck swelling, fever, ulceration and trismus. Sixteen patients (69.5%) had no significant comorbidity. The other 7 patients (30.4%) had at least one significant comorbidity: diabetes (5 patients, (21.7%), malnutrition (2, 8.7%), alcoholism (2, 8.7%). All cases received early and aggressive medical treatment followed by serial surgical debridement. Sixteen cases were treated on outpatient bases. The duration of hospital stay for those admitted ranged from 4 to 34 days .
Conclusion: Maintaining a high index of suspicion is crucially important for diagnosing CNF. Early diagnosis, timely resuscitation, and aggressive surgical debridement are the key to a successful clinical Necrotizing fasciitis requires early diagnosis and management to improve prognosis.
Keywords: Necrotising, fasciitis, odontogenic, infection
Description
13th Annual Scientific Conference, Faculty of Dental Sciences, College of Medicine University of Lagos
Keywords
Necrotising fasciitis , Factors , Odontogenic infections , Cranio-facial necrotizing (CFN) , Research Subject Categories::ODONTOLOGY
Citation
James O, Anorue EI, Adamson OO, Adeyemi MO, Adekunle AA, Ladeinde AL, Ogunlewe MO, Adeyemo WL. Necrotizing fasciitis: A five years review of cases seen at the Lagos University Teaching Hospital. 13th Annual Scientific Conference, Faculty of Dental Sciences, College of Medicine University of Lagos. 9th October, 2019.(Oral presentation)