Abstract
Necrotizing soft tissue infection of the head and neck is a life threatening condition that requires immediate surgical treatment, as well as broad spectrum antibiotics and supporting measures. It is a quite rare condition, and at Rikshospitalet, Oslo, Norway, there have been 65 patients hospitalized and treated for this condition during the last 10 years. In this article, we review the litterature published between 2001 and 2010, regarding such life threatening head and neck soft tissue infections. We focused on demographics, treatment, comorbidities and outcome. We searched MedLine, and found 40 publications. By using limitations and inclusion/exclusion-criterias we chose 15 articles that we wanted to include in our study, and we started analyzing the different data from these reports. The 15 articles had 206 patients in all. Most of these patients had the infection in the neck, with a varying extent. The most common etiology for these infections is a dental origin. Diabetes was the most encountered comorbidity. All the articles stressed the importance of a quick diagnosis, for a prompt surgical drainage and debridement of all necrotic tissue. All patients also received intravenous broad spectrum antibiotics, and it was reported that patients had several days in the ICU department. Most patients had several surgical revisions, and the average length of hospital stay for all the 206 patients was 22,5 days. 40 % had a tracheotomy to secure the airways. The condition has a high morbidity and mortality. Thoracic involvement, sepsis and progressive multi organ failure were factors leading to a poorer prognosis. The mortality of all the patients was 15,1 %.