Necrotising soft tissue infection in the head and neck region, 2017-2023

Tidsskr Nor Laegeforen. 2025 Oct 23;145(13). doi: 10.4045/tidsskr.25.0216. Print 2025 Nov 4.
[Article in English, Norwegian]

Abstract

Background: Necrotising soft tissue infection is a rare and severe infectious condition affecting the skin and underlying soft tissues. Since the COVID-19 pandemic, an increase has been reported internationally in cases caused by Streptococcus pyogenes (Group A Streptococcus, GAS). We have investigated the incidence, aetiology and resistance patterns of necrotising soft tissue infections in the head and neck region at the Department of Otorhinolaryngology, Oslo University Hospital, Rikshospitalet for the period 2017-2023.

Material and method: Retrospective review of medical records of patients treated for necrotising soft tissue infection before the pandemic (1 January 2017 to 11 March 2020), during the pandemic (12 March 2020 to 12 February 2022) and after the pandemic (13 February 2022 to 31 December 2023).

Results: Fifty-three patients with necrotising soft tissue infection were included in the study: 21 pre-pandemic, 7 during the pandemic and 25 post-pandemic. Group A Streptococcus was found in 27 patients, and all isolates were susceptible to penicillin.

Interpretation: In line with reports from other countries, the results from our department may indicate an increase in necrotising soft tissue infections caused by group A Streptococcus in the period following the pandemic.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • COVID-19* / epidemiology
  • Drug Resistance, Bacterial
  • Fasciitis, Necrotizing* / drug therapy
  • Fasciitis, Necrotizing* / epidemiology
  • Fasciitis, Necrotizing* / microbiology
  • Female
  • Head
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neck
  • Necrosis
  • Norway / epidemiology
  • Pandemics
  • Penicillins / therapeutic use
  • Retrospective Studies
  • SARS-CoV-2
  • Soft Tissue Infections* / drug therapy
  • Soft Tissue Infections* / epidemiology
  • Soft Tissue Infections* / microbiology
  • Streptococcal Infections* / drug therapy
  • Streptococcal Infections* / epidemiology
  • Streptococcal Infections* / microbiology
  • Streptococcus pyogenes / drug effects
  • Streptococcus pyogenes / isolation & purification
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Penicillins