The characteristics of oro-cervical necrotizing fasciitis—Comparison with severe cellulitis of oro-cervical region and necrotizing fasciitis of other body regions
Open Access
- 1 December 2021
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 16 (12), e0260740
- https://doi.org/10.1371/journal.pone.0260740
Abstract
Necrotizing fasciitis (NF) is an acute and life-threatening soft-tissue infection however rarely seen in oro-cervical region. Therefore, the details of oro-cervical NF (OCNF) are not well known. The purpose of this study was to investigate the characteristics of OCNF by comparing it with severe cellulitis of oro-cervical region (OCSC) or NF of other body regions (e.g., limb, perineum, and trunk) (BNF), respectively. At first, various risk factors for OCNF in oro-cervical severe infection (OCSI; composed of OCNF and OCSC), including neutrophil-to-lymphocyte ratio (NLR) and Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, were investigated by univariate and multivariate analyses. Next, the differences between OCNF and BNF, including inflammatory markers and mortality, were investigated. In the present study, 14 out of 231 OCSI patients had OCNF. Multivariate analyses of OCSI patients showed that NLR ≥15.3 and LRINEC score ≥6 points were significantly related to OCNF. During the same period, 17 patients had BNF. The OCNF group had significantly higher inflammatory markers than the BNF group when diagnosis, but significantly lower clinical stages at the time and mortality as outcomes. We found that compared to BNF, OCNF can be detected at lower clinical stage by using indexes, such as NLR and LRINEC score, besides clinical findings, which may help contributing to patient’s relief.This publication has 46 references indexed in Scilit:
- Validation of the laboratory risk indicator for necrotizing fasciitis (LRINEC) score for early diagnosis of necrotizing fasciitisTzu Chi Medical Journal, 2012
- Fournier’s Gangrene: A Monographic Urology Center Experience with Twenty PatientsUrologia Internationalis, 2009
- The fascia of the limbs and back – a reviewJournal of Anatomy, 2008
- Necrotizing Soft-Tissue Infection: Diagnosis and ManagementClinical Infectious Diseases, 2007
- The importance of serum creatine phosphokinase level in the early diagnosis and microbiological evaluation of necrotizing fasciitisJournal of the European Academy of Dermatology and Venereology, 2004
- Distortion of iron status indices by acute inflammation in older hospitalized patientsArchives of Gerontology and Geriatrics, 2004
- Necrotizing Fasciitis of the Face and NeckPlastic and Reconstructive Surgery, 1998
- Cervical Necrotizing Fasciitis: Clinical Manifestations and ManagementClinical Infectious Diseases, 1995
- Role of early and extensive surgery in the treatment of severe necrotizing soft tissue infectionBritish Journal of Surgery, 1993
- Necrotizing fasciitis. Importance of roentgenographic studies for soft-tissue gasJAMA, 1979