Skip to main content Accessibility help
×
Home

Synergistic necrotizing cellulitis resulting from peri-tonsillar abscess

  • P. J. Hadfield (a1), M. Motamed (a1) and G. W. Glover (a1)

Abstract

This case demonstrates the rare but potentially fatal condition of synergistic necrotizing cellulitis of the head and neck. Although similar to necrotizing fasciitis, this is more extreme as it also destroys muscle. Peri-tonsillar abscess is a recognized cause, but has not previously been described in this country, however it is a condition commonly referred to otolaryngologists and awareness of the complication of synergistic necrotizing cellulitis is necessary to allow early recognition and prompt treatment. This should be by broad-spectrum intravenous antibiotics with extensive surgical debridement and drainage procedures repeated as necessary. Although this case had a successful outcome, many patients do not survive, particularly if treatment is delayed or inadequate.

Copyright

Corresponding author

Address for correspondence: Miss P. J. Hadfield, F.R.C.S., Department of Otolaryngology, Charing Cross Hospital, Fulham Palace Road, London W6 8RF.

References

Hide All
Balcerak, R. J., Sisto, J. M., Bosack, R. C. L. (1988) Cervicofacial necrotizing fasciitis: report of three cases and literature review. Journal of Oral and Maxillofacial Surgery 46: 450459.
Burge, T. B. (1995) Necrotizing fasciitis - the hazards of delay. Journal of the Royal Society of Medicine 88: 342343.
Gaukroger, M. C. (1992) Cervicofacial necrotizing fasciitis. British Journal of Oral and Maxillofacial Surgery 30(2): 111114.
Greinwald, J. H., Wilson, J. F., Haggerty, P. J. (1995) Peritonsillar abscess: an unlikely cause of necrotizing fasciitis. Annals of Otology Rhinology and Laryngology 104: 133137.
Herr, R. D., Murdock, R. T., Davis, R. K. (1991) Serious soft tissue infections of the head and neck. American Family Physician 44(3): 878888.
Kaplan, D. M., Fliss, D. M., Shulman, H., Lieberman, A. (1995) Computed tomographic detection of necrotizing soft tissue infection of dental origin. Annals of Otology, Rhinology and Laryngology 104: 164166.
Kronish, J. W., McLeish, W. M. (1991) Eyelid necrosis and periorbital necrotizing fasciitis. Report of a case and review of the literature. Ophthalmology 98(1): 12921298.
Kurakin, A. V., Karapetiam, I. S., Volozhin, A. I., Sel'tsovskaia, G. D., Sudorgin, S. S., Asnina, S. A., Smirnova, E. N., Afanas'eva, E. A. (1993) The efficacy of using hyperbaric oxygen in different forms of an inflammatory process in the maxillofacial area. Stomatologiia - Moskia 72(2): 3032.
Lalwani, A. K., Kaplan, M. J. (1991) Mediastinal and thoracic complications of necrotizing fasciitis of the head and neck. Head and Neck Surgery 13: 531539.
Maisel, R. H., Karlen, R. (1994) Cervical necrotizing fasciitis. Laryngoscope 104(7): 795798.
Morrow, J. S., Gianoli, G. J. (1993) Craniocervical necrotizing fasciitis. Journal of Los Angeles State Medical Society 145(7): 297300.
Palchun, V. T., Kriukov, A. I., Vladimirova, V. V., Muratov, D. L. (1993) Para-tonsillitis-debatable questions of treatment techniques (1993). Vestnik Otorinolaryngologii 4: 2832.
Peled, M., Rubin, A., Laufer, D. (1994) Cervical necrotizing fasciitis. Harefuah 126(11): 651654.
Rippe, D. H. (1991) Intensive Care Medicine, 2nd Edition, Little, Brown and Co., Boston, MA, pp. 13371339.
Rouse, T. M., Malagoni, M. A., Schulte, W. J. (1982) Necrotizing fasciitis: a preventable disaster. Surgery 92: 765770.
Smith, G. A., Hemingway, W. G. (1978) Infections of the head and neck. Medical Times 106: 3339.
Spankus, E. M., Flint, P. W., Smith, R. J. H., Millar, R. H. (1984) Craniocervical necrotizing fasciitis. Otolaryngology - Head and Neck Surgery 92: 261265.
Stone, H. H., Martin, J. D. (1972) Synergistic necrotizing cellulitis. Annals of Surgery 175: 702.
Tovi, F., Flis, D. M., Zirkin, H. J. (1991) Necrotizing softtissue infections in the head and neck; a clinicopathological study. Laryngoscope 101: 619625.
Ward, R. G., Walsh, M. S. (1991) Necrotizing fasciitis: 10 years' experience in a district general hospital. British Journal of Surgery 78: 488.
Wenig, B. L., Shikowitz, M. J., Abramson, A. L. (1984) Necrotizing fasciitis as a lethal complication of peritonsillar abscess. Laryngoscope 94: 15761579.
Williams, S. R., Carruth, J. A., Brightwell, A. P. (1992) Necrotizing fasciitis of the face without significant trauma. Clinical Otolaryngology 17: 344350.
Wills, P. I., Vernon, R. P. Jr. (1981) Complications of space infections of the head and neck. Laryngoscope 91: 11261136.
Wilson, B. (1952) Necrotizing fasciitis. American Surgeon 18: 416431.
Yamaoka, M., Furusawa, K., Uematsu, T., Yasuda, K. (1994) Early evaluation of necrotizing fasciitis with use of CT. Journal of Craniomaxillofacial Surgery 22(5): 268271.
Zakharov, I. S., Orlova, N. V. (1990) Anaerobic nonclostridial microflora in necrotic phlegmons of the face and neck. Soviet Medicine 10: 110113.

Keywords

Synergistic necrotizing cellulitis resulting from peri-tonsillar abscess

  • P. J. Hadfield (a1), M. Motamed (a1) and G. W. Glover (a1)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed