Cervical necrotizing fasciitis: an overlooked diagnosis of a fatal disease.

Background: Necrotizing fasciitis of the neck is a rare potentially lethal condition if not early diagnosed and managed. We aimed to study the clinical presentation, radiological and microbiological diagnosis, management, and surgical outcome of patients having cervical necrotizing fasciitis (CNF). Materials and methods: We retrospectively studied patients having a final diagnosis of CNF who were treated at Al Ain Hospital during the period of January 2000 to December 2016. Results: Six patients with CNF were studied. Diabetes mellitus was the most common predisposing factor (83.3%). All patients presented with a painful neck swelling. The most common source of infection was odontogenic. Mixed microbiological flora was present in five patients. Five patients underwent CT scan of the head and neck with a positive finding of gas in all of them. Repeated aggressive surgical debridement in combination with antibiotic therapy was adopted. Four patients (66.7%) developed superior mediastinitis, two had septicemia, and one patient had a perforated duodenal ulcer. One patient died (overall mortality 16.7%). 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 outcome. [ABSTRACT FROM AUTHOR]

背景：如果没有早期诊断和治疗, 颈部坏死性筋膜炎就会是可能致命的罕见疾病。我们的目的是研究患有颈部坏死性筋膜炎（CNF）的患者的临床表现、放射学和微生物诊断、治疗和手术结果。 材料和方法：我们回顾性研究了2000年1月至2016年12月期间在艾因医院接受治疗的最终诊断为CNF的患者。 结果：研究了6例CNF患者。糖尿病是最常见的诱发因素（83.3%）。所有患者表现为疼痛的颈部肿胀。最常见的感染源是牙源性的。五名患者带有混合微生物菌群。五名患者的头颈部接受了CT扫描, 均发现带有气体。采用了反复侵袭性外科清创与抗生素治疗的综合应用。 4例（66.7%）发生良性纵隔炎, 2例发生败血病, 1例发生十二指肠溃疡。一名病人死亡（总死亡率为16.7%）。 结论：保持高度警觉性对于诊断CNF至关重要。早期诊断、及时治疗和大范围手术清创是临床成功的关键 [ABSTRACT FROM AUTHOR]