Faculty Collaboration Database

Pediatric cervicofacial necrotizing fasciitis: a case report and review of a 10-year national pediatric database. Arch Otolaryngol Head Neck Surg 2012 Apr;138(4):372-5

Date

04/18/2012

Pubmed ID

22508620

Pubmed Central ID

PMC4422338

DOI

10.1001/archoto.2012.119

Scopus ID

2-s2.0-84860212950 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

OBJECTIVE: To present a case of a pediatric cervicofacial necrotizing fasciitis (NF), a rapidly progressive infection, and a review of a 10-year pediatric inpatient database.

DESIGN: Case report and review.

SETTING: Pediatric intensive care unit.

PATIENTS: A healthy 5-year-old male who developed NF of the lower lip 36 hours following minor trauma. International Classification of Diseases, Ninth Revision, code 728.86 (NF), was the inclusion criteria for the Kids' Inpatient Database (KID) in 1997 and 2006.

RESULTS: A pediatric case is presented with a thorough photographic record demonstrating the need for rapid diagnosis and treatment. In a review of the KID from 1997 and 2006, the relative risk of being discharged with NF in 2006 vs 1997 was 1.4 (95% CI, 9.95-2.28). Age at diagnosis of NF was older in 2006 compared with 1997 (11.5 years vs 8.05 years; P < .001). Deaths with a diagnosis of NF increased from 1997 compared with 2006: from 3.9% to 5.4%. In 2006, the odds of death were 15.1 times higher in pediatric discharges with a diagnosis of NF compared with discharges without a diagnosis of NF (P < .001; 95% CI, 9.3-23.1).

CONCLUSIONS: Even with the advent of new treatments and antibiotics, the incidence and death rates of NF have changed little over the past 10 years. While it is still a rare diagnosis, knowledge and awareness of necrotizing fasciitis with aggressive medical and surgical treatment are still the foundation in disease survival.

Author List

King E, Chun R, Sulman C

Author

Robert H. Chun MD Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anti-Bacterial Agents
Child, Preschool
Combined Modality Therapy
Databases, Factual
Debridement
Fasciitis, Necrotizing
Humans
Hyperbaric Oxygenation
Lip
Lip Diseases
Male
United States
Wisconsin