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Cervical necrotizing fasciitis: descriptive, retrospective analysis of 59 cases treated at a single center

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A Letter to the Editor to this article was published on 10 February 2017

Abstract

To provide retrospective, descriptive information on patients with cervical necrotizing fasciitis treated at a single center during the years 1998–2014, and to evaluate the outcome of a newly introduced treatment strategy. Retrospective analysis of clinical data obtained from medical records. Mortality, pre-morbidity, severity of illness, primary site of infection, type of bacteria, time parameters. The observed 3-month mortality was 6/59 (10 %). The most common initial foci of the infection were pharyngeal, dental or hypopharyngeal. The most common pathogen was Streptococcus milleri bacteria within the Streptococcus anginosus group (66 % of the cases). Using a combined treatment with early surgical debridement combined with hyperbaric oxygen treatment, it is possible to reduce the mortality rate among patients suffering from cervical necrotizing fasciitis, compared to the expected mortality rate and to previous historical reports. Data indicated that early onset of hyperbaric oxygen treatment may have a positive impact on survival rate, but no identifiable factor was found to prognosticate outcome.

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Acknowledgments

The authors wish to thank Anna Westman and Bengt Gårdlund for valuable advice on microbiological aspects.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Region Gotland, Visby Lasarett, Sankt Göransgatan 5, 621 55, Visby, Sweden

    Johanna Elander

  2. Department of Anaesthesia, Surgical Services and Intensive Care, Karolinska University Hospital, Stockholm, Sweden

    Michael Nekludov & Agneta Larsson

  3. Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden

    Johanna Elander, Britt Nordlander & Jonas Hydman

  4. Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden

    Staffan Eksborg

  5. Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden

    Agneta Larsson

Authors
  1. Johanna Elander
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  2. Michael Nekludov
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  3. Agneta Larsson
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  4. Britt Nordlander
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  5. Staffan Eksborg
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  6. Jonas Hydman
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Corresponding author

Correspondence to Johanna Elander.

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Author one to five declares that he/she has no conflict of interest.

Ethical approval

The study is approved by the Swedish Central Ethical Review Board (Dnr 2015/73-31/2). This article does not contain any studies with human participants or animals performed by any of the authors.

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Elander, J., Nekludov, M., Larsson, A. et al. Cervical necrotizing fasciitis: descriptive, retrospective analysis of 59 cases treated at a single center. Eur Arch Otorhinolaryngol 273, 4461–4467 (2016). https://doi.org/10.1007/s00405-016-4126-y

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  • DOI: https://doi.org/10.1007/s00405-016-4126-y

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