Cervical necrotizing fasciitis : 10 years' experience at a single institution
To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution. Retrospective clinical investigation. We reviewed the charts of 20 consecutive patients hospitalized in our Intensive Care Unit bet...
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| Veröffentlicht in: | Intensive care medicine 1999-08, Vol.25 (8), p.829-834 |
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| creator | MOHAMMEDI, I CERUSE, P DUPERRET, S VEDRINNE, J.-M BOULETREAU, P |
| description | To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution.
Retrospective clinical investigation.
We reviewed the charts of 20 consecutive patients hospitalized in our Intensive Care Unit between January 1987 and June 1998 with the diagnosis of cervical necrotizing fasciitis.
All the patients required mechanical ventilation. Four of them had mediastinal involvement. The organisms most commonly implicated included Streptococcus, Prevotella, and Peptostreptococcus species. Patients with adequate surgery had a better outcome than those with inadequate surgical procedures. Because no evidence-based recommendations exist in the field of head and neck infections, hyperbaric oxygen was not used as adjunctive therapy. Of the 20 patients, 3 (15 %) died.
The main finding of this study is that prompt, rather than delayed, surgical débridement correlates with a decrease in morbidity and mortality. However, no definite conclusion is justified due to the relatively small number of patients. Immediate radical débridement, and early redébridement if needed, appropriate antibiotics and intensive care support are critical in controlling these life-threatening infections. |
| doi_str_mv | 10.1007/s001340050959 |
| format | Article |
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Retrospective clinical investigation.
We reviewed the charts of 20 consecutive patients hospitalized in our Intensive Care Unit between January 1987 and June 1998 with the diagnosis of cervical necrotizing fasciitis.
All the patients required mechanical ventilation. Four of them had mediastinal involvement. The organisms most commonly implicated included Streptococcus, Prevotella, and Peptostreptococcus species. Patients with adequate surgery had a better outcome than those with inadequate surgical procedures. Because no evidence-based recommendations exist in the field of head and neck infections, hyperbaric oxygen was not used as adjunctive therapy. Of the 20 patients, 3 (15 %) died.
The main finding of this study is that prompt, rather than delayed, surgical débridement correlates with a decrease in morbidity and mortality. However, no definite conclusion is justified due to the relatively small number of patients. Immediate radical débridement, and early redébridement if needed, appropriate antibiotics and intensive care support are critical in controlling these life-threatening infections.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s001340050959</identifier><identifier>PMID: 10447540</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Bacteria ; Biological and medical sciences ; Candida albicans - isolation & purification ; Child ; Debridement ; Emergency and intensive care: infection, septic shock ; Fasciitis, Necrotizing - microbiology ; Fasciitis, Necrotizing - mortality ; Fasciitis, Necrotizing - therapy ; Female ; Hospitals ; Humans ; Infections ; Intensive care ; Intensive care medicine ; Male ; Medical Records ; Medical sciences ; Middle Aged ; Mortality ; Neck ; Necrotizing fasciitis ; Prevotella - isolation & purification ; Reoperation ; Respiration, Artificial ; Retrospective Studies ; Severity of Illness Index ; Soft Tissue Infections - microbiology ; Soft Tissue Infections - mortality ; Soft Tissue Infections - therapy ; Staphylococcus aureus - isolation & purification ; Streptococcus - isolation & purification ; Surgery ; Treatment Outcome ; Ventilators</subject><ispartof>Intensive care medicine, 1999-08, Vol.25 (8), p.829-834</ispartof><rights>1999 INIST-CNRS</rights><rights>Springer-Verlag Berlin Heidelberg 1999</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-176aa9c592a55cdebd3a3b5193eabb8cf10700c2eec0d66c739dfa28ffca4e433</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1929178$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10447540$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MOHAMMEDI, I</creatorcontrib><creatorcontrib>CERUSE, P</creatorcontrib><creatorcontrib>DUPERRET, S</creatorcontrib><creatorcontrib>VEDRINNE, J.-M</creatorcontrib><creatorcontrib>BOULETREAU, P</creatorcontrib><title>Cervical necrotizing fasciitis : 10 years' experience at a single institution</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><description>To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution.
Retrospective clinical investigation.
We reviewed the charts of 20 consecutive patients hospitalized in our Intensive Care Unit between January 1987 and June 1998 with the diagnosis of cervical necrotizing fasciitis.
All the patients required mechanical ventilation. Four of them had mediastinal involvement. The organisms most commonly implicated included Streptococcus, Prevotella, and Peptostreptococcus species. Patients with adequate surgery had a better outcome than those with inadequate surgical procedures. Because no evidence-based recommendations exist in the field of head and neck infections, hyperbaric oxygen was not used as adjunctive therapy. Of the 20 patients, 3 (15 %) died.
The main finding of this study is that prompt, rather than delayed, surgical débridement correlates with a decrease in morbidity and mortality. However, no definite conclusion is justified due to the relatively small number of patients. Immediate radical débridement, and early redébridement if needed, appropriate antibiotics and intensive care support are critical in controlling these life-threatening infections.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Bacteria</subject><subject>Biological and medical sciences</subject><subject>Candida albicans - isolation & purification</subject><subject>Child</subject><subject>Debridement</subject><subject>Emergency and intensive care: infection, septic shock</subject><subject>Fasciitis, Necrotizing - microbiology</subject><subject>Fasciitis, Necrotizing - mortality</subject><subject>Fasciitis, Necrotizing - therapy</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infections</subject><subject>Intensive care</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical Records</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neck</subject><subject>Necrotizing fasciitis</subject><subject>Prevotella - isolation & purification</subject><subject>Reoperation</subject><subject>Respiration, Artificial</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Soft Tissue Infections - microbiology</subject><subject>Soft Tissue Infections - mortality</subject><subject>Soft Tissue Infections - therapy</subject><subject>Staphylococcus aureus - isolation & purification</subject><subject>Streptococcus - isolation & purification</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Ventilators</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpd0MtLxDAQx_Egirs-jl4liOipOmmStvEmiy9QvOi5TNOpZOm2a9KK-tcb2QUfp7l8GH58GTsQcCYA8vMAIKQC0GC02WBToWSaiFQWm2wKUqWJylQ6YTshzKPMMy222USAUrlWMGUPM_JvzmLLO7K-H9yn6154g8E6N7jAL7gA_kHowymn9yV5R50ljgNHHiJtibsuDG4YB9d3e2yrwTbQ_vrusufrq6fZbXL_eHM3u7xPrCzUkMQZiMZqk6LWtqaqligrLYwkrKrCNgJyAJsSWaizzObS1A2mRdNYVKSk3GUnq79L37-OFIZy4YKltsWO-jGUmTGZzk0W4dE_OO9H38VtpTFSZ0pqiChZoRggBE9NufRugf6jFFB-Ry7_RI7-cP10rBZU_9KrqhEcr0HsiG3jsbMu_DiTGpEX8gvNz4NZ</recordid><startdate>19990801</startdate><enddate>19990801</enddate><creator>MOHAMMEDI, I</creator><creator>CERUSE, P</creator><creator>DUPERRET, S</creator><creator>VEDRINNE, J.-M</creator><creator>BOULETREAU, P</creator><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>19990801</creationdate><title>Cervical necrotizing fasciitis : 10 years' experience at a single institution</title><author>MOHAMMEDI, I ; CERUSE, P ; DUPERRET, S ; VEDRINNE, J.-M ; BOULETREAU, P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-176aa9c592a55cdebd3a3b5193eabb8cf10700c2eec0d66c739dfa28ffca4e433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Bacteria</topic><topic>Biological and medical sciences</topic><topic>Candida albicans - isolation & purification</topic><topic>Child</topic><topic>Debridement</topic><topic>Emergency and intensive care: infection, septic shock</topic><topic>Fasciitis, Necrotizing - microbiology</topic><topic>Fasciitis, Necrotizing - mortality</topic><topic>Fasciitis, Necrotizing - therapy</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infections</topic><topic>Intensive care</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical Records</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neck</topic><topic>Necrotizing fasciitis</topic><topic>Prevotella - isolation & purification</topic><topic>Reoperation</topic><topic>Respiration, Artificial</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Soft Tissue Infections - microbiology</topic><topic>Soft Tissue Infections - mortality</topic><topic>Soft Tissue Infections - therapy</topic><topic>Staphylococcus aureus - isolation & purification</topic><topic>Streptococcus - isolation & purification</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MOHAMMEDI, I</creatorcontrib><creatorcontrib>CERUSE, P</creatorcontrib><creatorcontrib>DUPERRET, S</creatorcontrib><creatorcontrib>VEDRINNE, J.-M</creatorcontrib><creatorcontrib>BOULETREAU, P</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MOHAMMEDI, I</au><au>CERUSE, P</au><au>DUPERRET, S</au><au>VEDRINNE, J.-M</au><au>BOULETREAU, P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cervical necrotizing fasciitis : 10 years' experience at a single institution</atitle><jtitle>Intensive care medicine</jtitle><addtitle>Intensive Care Med</addtitle><date>1999-08-01</date><risdate>1999</risdate><volume>25</volume><issue>8</issue><spage>829</spage><epage>834</epage><pages>829-834</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution.
Retrospective clinical investigation.
We reviewed the charts of 20 consecutive patients hospitalized in our Intensive Care Unit between January 1987 and June 1998 with the diagnosis of cervical necrotizing fasciitis.
All the patients required mechanical ventilation. Four of them had mediastinal involvement. The organisms most commonly implicated included Streptococcus, Prevotella, and Peptostreptococcus species. Patients with adequate surgery had a better outcome than those with inadequate surgical procedures. Because no evidence-based recommendations exist in the field of head and neck infections, hyperbaric oxygen was not used as adjunctive therapy. Of the 20 patients, 3 (15 %) died.
The main finding of this study is that prompt, rather than delayed, surgical débridement correlates with a decrease in morbidity and mortality. However, no definite conclusion is justified due to the relatively small number of patients. Immediate radical débridement, and early redébridement if needed, appropriate antibiotics and intensive care support are critical in controlling these life-threatening infections.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>10447540</pmid><doi>10.1007/s001340050959</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anti-Bacterial Agents - therapeutic use Antibiotics Bacteria Biological and medical sciences Candida albicans - isolation & purification Child Debridement Emergency and intensive care: infection, septic shock Fasciitis, Necrotizing - microbiology Fasciitis, Necrotizing - mortality Fasciitis, Necrotizing - therapy Female Hospitals Humans Infections Intensive care Intensive care medicine Male Medical Records Medical sciences Middle Aged Mortality Neck Necrotizing fasciitis Prevotella - isolation & purification Reoperation Respiration, Artificial Retrospective Studies Severity of Illness Index Soft Tissue Infections - microbiology Soft Tissue Infections - mortality Soft Tissue Infections - therapy Staphylococcus aureus - isolation & purification Streptococcus - isolation & purification Surgery Treatment Outcome Ventilators |
| title | Cervical necrotizing fasciitis : 10 years' experience at a single institution |
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