The Journal of Laryngology & Otology

Clinical Records

Novel management of cervical necrotising fasciitis in a developing country: case report

A Salisua1 c1, A A Adeosuna1, N H Emma-Nzekwuea1 and S B Abubakara2

a1 Department of ENT, University College Hospital, Ibadan, Nigeria

a2 Department of Microbiology, University College Hospital, Ibadan, Nigeria

Abstract

Objective: We report a rare case of cervical necrotising fasciitis arising from poorly managed acute tonsillitis.

Case report: A 23-year-old woman presented with a two-week history of fever and an eight-day history of painful neck swelling. Nine days before presentation, she had received digital manipulation of her throat by a neighbour, which had worsened her throat pain. There was associated progressive generalised neck swelling, odynophagia, dysphagia and dyspnoea. An X-ray of the neck soft tissue showed multiple gas collections.

Conclusion: Cervical necrotising fasciitis is rare and usually odontogenic in origin. It is associated with a high mortality rate. Our patient responded to aggressive daily bedside wound debridements and dressings, appropriate intravenous antibiotics and high-protein nutritional support. In this way, exploration under general anaesthesia was avoided, in a developing country with limited facilities.

(Accepted May 12 2010)

(Online publication October 12 2010)

Correspondence:

c1 Address for correspondence: Dr A Salisu, Consultant ENT Surgeon, Federal Medical Centre, Gusau, Zamfara State, Nigeria E-mail: salisent@gmail.com

Footnotes

Dr A Salisu takes responsibility for the integrity of the content of the paper

Competing interests: None declared