Diagnosis and management of necrotizing fasciitis of the head and neck.

Necrotizing fasciitis is a rapidly progressing and life-threatening soft tissue infection that often affects the abdominal wall, perineum, or extremities following surgery or trauma. It predominantly occurs in elderly and immunocompromised patients. It is rarely seen in the head and neck region. Necrotizing fasciitis of the head and neck carries high rates of morbidity and mortality. Symptoms usually develop quickly and well-timed diagnosis is critical to optimizing outcome. Diagnosis is based on a combination of clinical history, Gram staining and culture, imaging and surgical exploration. Early and aggressive surgical management and urgent parenteral antibiotic therapy are critical to optimizing outcome.