Department of Dental Services, Muhimbili National Hospital, Dar es Salaam, Tanzania.
Department of oral and maxillofacial surgery, Muhimbili University of Health and Allied Sciences, P.O. Box 65014, Dar es Salaam, Tanzania.
BMC Infect Dis. 2019 Jul 19;19(1):642. doi: 10.1186/s12879-019-4267-x.
Cervicofacial necrotizing fasciitis (NF) is a rare life-threatening infection in the head and neck region that characteristically spreads along the fascial planes to involve subcutaneous tissues, fascia and fat, however, in late stages it can involve muscles and skin. The aim of this study was to determine the occurrence of cervicofacial NF among patients attending treatment at the Muhimbili National Hospital (MNH).
This was a prospective descriptive cross-sectional hospital-based study which was carried at Muhimbili National Hospital (MNH) from May 2013 to April 2014. It included 42 patients with cervicofacial NF. They were interviewed for demographic information, chief complaints, symptoms, duration and treatment received before reporting at MNH. A thorough assessment of general health condition of the patients and laboratory investigations were followed by management according to MNH protocol. Data obtained from these patients were analyzed using Statistical Package for Social Sciences SPSS 20.
During the study period, 151 patients reported at MNH with odontogenic infections. A total of 42 (27.8%) patients satisfied our diagnostic criteria for cervicofacial NF. The age range was 15 years to 83 years (mean 43.95, SD +/- 16.16). Greater (35.7%) proportion was in the age group of 30-39 years with 31 (73.8%) males and 11 (27.2%) females making a male to female ratio of 2.8:1. Fifteen (35.7%) patients had at least one co-existing systemic condition, which included anaemia in 5 (11.9%) patients, followed by diabetes mellitus (DM) and malnutrition 4 (9.5%) patients each and HIV infection 2 (4.8%) patients. Others were combination of; HIV infection and malnutrition, HIV infection and anaemia and diabetes mellitus and anaemia each in one (2.4%) patient. There was a mortality of 42.9% comprising of 14 (33.3%) males and 4 (9.6%) females.
Cervicofacial NF is a polymicrobial infection, requiring surgery, antibiotics and management of co-existing systemic conditions. Anaemia, diabetes mellitus and malnutrition were the main co-existing systemic conditions. The rather high mortality was mainly attributable to late reporting.
颈部坏死性筋膜炎（NF）是一种罕见的危及生命的头颈部感染，其特征是沿着筋膜平面扩散，累及皮下组织、筋膜和脂肪，但在晚期可累及肌肉和皮肤。本研究旨在确定在穆希比利国家医院（MNH）接受治疗的患者中颈部坏死性筋膜炎的发生情况。
这是一项前瞻性描述性的基于医院的研究，于 2013 年 5 月至 2014 年 4 月在穆希比利国家医院（MNH）进行。它包括 42 例颈部坏死性筋膜炎患者。对他们进行了人口统计学信息、主要症状、症状持续时间和在 MNH 就诊前接受的治疗的采访。对患者的一般健康状况进行了全面评估，并进行了实验室检查，然后根据 MNH 方案进行了治疗。从这些患者中获得的数据使用社会科学统计软件包 SPSS 20 进行分析。
在研究期间，有 151 名患者因牙源性感染到 MNH 就诊。共有 42 名（27.8%）患者符合我们的颈部坏死性筋膜炎诊断标准。年龄范围为 15 岁至 83 岁（平均年龄 43.95，标准差 +/- 16.16）。比例最大（35.7%）的年龄组为 30-39 岁，其中 31 名（73.8%）为男性，11 名（27.2%）为女性，男女比例为 2.8:1。15 名（35.7%）患者至少有一种并存的系统性疾病，其中包括 5 名（11.9%）贫血患者，其次是糖尿病（DM）和营养不良各 4 名（9.5%）患者，艾滋病毒感染 2 名（4.8%）患者。其他分别为：艾滋病毒感染和营养不良、艾滋病毒感染和贫血、糖尿病和贫血各 1 例（2.4%）。死亡率为 42.9%，包括 14 名（33.3%）男性和 4 名（9.6%）女性。
颈部坏死性筋膜炎是一种多微生物感染，需要手术、抗生素和治疗并存的系统性疾病。贫血、糖尿病和营养不良是主要的并存系统性疾病。死亡率较高主要归因于晚期报告。
