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Patricia C. Sabb, MD; Bryan S. Sires, MD, PhD; Bradley N. Lemke, MD; Jeffrey A. Goldstein, MD
Madison, Wis

Arch Ophthalmol. 1995;113(12):1571.

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Necrotizing fasciitis is a potentially fatal infection of the skin and superficial fascia. Essential management includes early diagnosis, prompt surgical débridement, and appropriate parenteral antibiotics.

Report of a Case.

Necrotizing fasciitis of the deep neck, face, and chest wall developed in a previously healthy 52-year-old man. He had a 3-day history of odynophagia and dysphagia, a temperature of 39.1°C, and a white blood cell count of 23 x10⁹/L (23 000 mm³). There was no history of trauma or contact with animals.

A retropharyngeal abscess was identified on computed tomography of the head, leading to incision, drainage, and therapy with broad-spectrum intravenous antibiotics. The next day increased swelling, erythema, and tenderness of the head and neck regions developed, with progression onto the anterior chest wall (Figure 1). He underwent emergent surgical fasciotomy with débridement, which was repeated 3 days later. Cultures revealed β-hemolytic streptococcus, Group C.

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