Suárez Aldo, Vicente Mario, Tomás Jose A, Floría Luis M, Delhom José, Baquero Mari C
Oral and Maxillofacial Surgery Department, Insular Hospital, Las Palmas, Spain.
Oral and Maxillofacial Surgery Department, Insular Hospital, Las Palmas, Spain.
Am J Emerg Med. 2014 Nov;32(11):1441.e5-6. doi: 10.1016/j.ajem.2014.04.018. Epub 2014 Apr 18.
Cervical necrotizing fasciitis (CNF) is a potentially fatal infection characterized by generalized necrosis of the cervical fascia that progresses rapidly. The incidence of this entity corresponds to 2.6% of all infections of the head and neck. The most frequent primary origin is dental infection, although other causes exist that should be evaluated.Delay in the diagnosis of this entity may lead to rapid progression and fatal outcome. Patients often present immunosuppression or systemic diseases that predispose them to this pathology. Cervical necrotizing fasciitis is associated with mortality rates of 7% to 20% depending on the extension of the cervical lesion. The highest rates correspond to cases that progress to mediastinitis or septic shock, which are the main and most frequent complications. Early detection and adequate emergency treatment are critical in the management of these patients and may reduce morbimortality and improve survival. The emergency services should be prepared to manage such cases efficiently, through a multidisciplinary treatment by coordinating emergency surgery with critical support and clinical stabilization of patients.We present a case of CNF of non odontogenic origin managed in our hospital.
颈部坏死性筋膜炎（CNF）是一种潜在的致命感染，其特征为颈部筋膜广泛坏死且进展迅速。该病症的发病率占头颈部所有感染的2.6%。最常见的原发病因是牙源性感染，不过也存在其他病因，对此应进行评估。对该病症的诊断延误可能导致病情迅速进展并造成致命后果。患者常存在免疫抑制或全身性疾病，使他们易患此病。颈部坏死性筋膜炎的死亡率在7%至20%之间，具体取决于颈部病变的范围。死亡率最高的情况是进展为纵隔炎或感染性休克的病例，这是主要且最常见的并发症。早期检测和充分的急诊治疗对于这些患者的管理至关重要，可能会降低病死率并提高生存率。急救服务部门应做好准备，通过多学科治疗，协调急诊手术与关键支持以及患者的临床稳定，有效地处理此类病例。我们展示了我院处理的一例非牙源性起源的颈部坏死性筋膜炎病例。
