Necrotizing fasciitis due to a peritonsillar abscess [Nekrotisierende Fasziitis bei Peritonsillarabszess]

Background: Necrotizing fasciitis is a potentially life-threatening complication of severe cervical soft tissue inflammation. The characteristic feature is the rapid spread of the infection, which descends and potentially leads to mediastinitis and sepsis. Methods: Within a year, 4 patients with peritonsillar abscess (PTA) and necrotizing fasciitis were treated at Dessau Medical Center. Therapy consisted of abscess tonsillectomy, immediate surgical debridement, extensive wound drainage, early tracheostomy, and systemic antibiotics. Results: Symptoms decreased after intensive care and surgical removal. All patients were discharged after wound healing. The death of the oldest, multimorbid patient several weeks later was ascribed to the accompanying diseases. Conclusion: Early diagnosis, aggressive surgical debridement in association with tracheostomy and intravenous antibiotic therapy may reduce mortality significantly. © 2012 Springer-Verlag Berlin Heidelberg.