Management of facial necrotizing fasciitis

Eur Arch Otorhinolaryngol. 2009 Mar;266(3):325-31. doi: 10.1007/s00405-008-0870-y. Epub 2008 Nov 29.


Necrotizing fasciitis is a progressive, life-threatening, bacterial infection of the skin, the subcutaneous tissue and the underlying fascia, in most cases caused by ss-hemolytic group A streptococcus. Only early diagnosis and aggressive therapy including broad spectrum antibiotics and surgical intervention can avoid systemic toxicity with a high mortality rate. This uncommon disease generally occurs in the lower extremities and trunk, and only rarely affects the head and neck region. When located in the face necrotizing fasciitis is associated with severe cosmetic and functional restrictions due to the invasive infection and often to the necessary surgical treatment. Generally surgical intervention cannot be performed in the face as aggressively as in the extremities and trunk, since a lot of vital structures are found in a relatively small area. In the following article, we present the successful diagnostic and therapeutic management of an isolated facial necrotizing fasciitis as a consequence of a nasal bone fracture with a minor dermal cut.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Antifungal Agents / therapeutic use*
  • Clindamycin / therapeutic use*
  • Disease Progression
  • Drug Combinations
  • Drug Therapy, Combination
  • Eye
  • Fasciitis, Necrotizing / diagnostic imaging
  • Fasciitis, Necrotizing / drug therapy*
  • Fasciitis, Necrotizing / microbiology*
  • Female
  • Humans
  • Metronidazole / therapeutic use*
  • Penicillins / therapeutic use*
  • Streptococcal Infections / complications*
  • Streptococcus pyogenes / isolation & purification
  • Sulbactam / therapeutic use*
  • Tomography, X-Ray Computed


  • Anti-Bacterial Agents
  • Antifungal Agents
  • Drug Combinations
  • Penicillins
  • Metronidazole
  • Clindamycin
  • Sulbactam