A rare case of necrotizing fasciitis of the external ear

A 15 months old boy was referred to our emergency department with fever since 3 days and bilateral otorrhoe. Examination of the ears revealed an edematous and erythematous pinna at the left side, with necrosis of the tragus. Because of progression of the necrosis, an urgent debridement was performed and antimicrobial therapy was started. Necrotizing fasciitis (NF) is a progressive and potential fatal bacterial infection of the subcutaneous tissue, rapidly spreading along fascial planes. In the head and neck area NF is very uncommon. Most cases involve only the neck, usually from infections of dental or pharyngeal origin. In the English literature we only found one case of NF extending from an external otitis in an adult patient. (C) 2013 Elsevier Ireland Ltd. All rights reserved.