Abstract:
Background: Cervicofacial necrotizing fasciitis (NF) is a rare life-threatening infection in the head and neck region
that characteristically spreads along the fascial planes to involve subcutaneous tissues, fascia and fat, however, in
late stages it can involve muscles and skin. The aim of this study was to determine the occurrence of cervicofacial
NF among patients attending treatment at the Muhimbili National Hospital (MNH).
Methods: This was a prospective descriptive cross-sectional hospital-based study which was carried at Muhimbili
National Hospital (MNH) from May 2013 to April 2014. It included 42 patients with cervicofacial NF. They were
interviewed for demographic information, chief complaints, symptoms, duration and treatment received before
reporting at MNH. A thorough assessment of general health condition of the patients and laboratory investigations
were followed by management according to MNH protocol. Data obtained from these patients were analyzed
using Statistical Package for Social Sciences SPSS 20.
Results: During the study period, 151 patients reported at MNH with odontogenic infections. A total of 42 (27.8%)
patients satisfied our diagnostic criteria for cervicofacial NF. The age range was 15 years to 83 years (mean 43.95, SD
+/− 16.16). Greater (35.7%) proportion was in the age group of 30–39 years with 31 (73.8%) males and 11 (27.2%)
females making a male to female ratio of 2.8:1.
Fifteen (35.7%) patients had at least one co-existing systemic condition, which included anaemia in 5 (11.9%)
patients, followed by diabetes mellitus (DM) and malnutrition 4 (9.5%) patients each and HIV infection 2 (4.8%)
patients. Others were combination of; HIV infection and malnutrition, HIV infection and anaemia and diabetes
mellitus and anaemia each in one (2.4%) patient. There was a mortality of 42.9% comprising of 14 (33.3%) males
and 4 (9.6%) females.
Conclusions: Cervicofacial NF is a polymicrobial infection, requiring surgery, antibiotics and management of
co-existing systemic conditions. Anaemia, diabetes mellitus and malnutrition were the main co-existing
systemic conditions. The rather high mortality was mainly attributable to late reporting.
