Multidisciplinary Approach in Rare, Fulminant-Progressing, and Life-Threatening Facial Necrotizing Fasciitis

(1) Background: Necrotizing fasciitis is known as a severe condition with a high risk of mortality, placing it among the most feared infections. In most cases, it has a polymicrobial etiology (type 1), requiring complex treatment that is continuously adapted to the evolving microbiological status. T...

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Main Authors: Mihaela Pertea, Stefana Luca, Raluca Tatar, Bogdan Huzum, Mihai Ciofu, Vladimir Poroch, Dragos Octavian Palade, Daniela Vrinceanu, Mihail Balan, Oxana Madalina Grosu
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Infectious Disease Reports
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Online Access:https://www.mdpi.com/2036-7449/16/6/84
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author Mihaela Pertea
Stefana Luca
Raluca Tatar
Bogdan Huzum
Mihai Ciofu
Vladimir Poroch
Dragos Octavian Palade
Daniela Vrinceanu
Mihail Balan
Oxana Madalina Grosu
author_facet Mihaela Pertea
Stefana Luca
Raluca Tatar
Bogdan Huzum
Mihai Ciofu
Vladimir Poroch
Dragos Octavian Palade
Daniela Vrinceanu
Mihail Balan
Oxana Madalina Grosu
author_sort Mihaela Pertea
collection DOAJ
description (1) Background: Necrotizing fasciitis is known as a severe condition with a high risk of mortality, placing it among the most feared infections. In most cases, it has a polymicrobial etiology (type 1), requiring complex treatment that is continuously adapted to the evolving microbiological status. The facial localization of the disease is rare, fulminant progressing, and is often life-threatening. (2) Methods: We present the case of a patient with multiple comorbidities who, following trauma to the nasal dorsum, developed a wound with a rapid and severe progression to extensive bilateral periorbital necrosis. This was accompanied by a dramatic deterioration in their general condition, a polymicrobial biological status, and fluctuating progression despite instituted treatment (both medical and surgical). (3) Results: The patient required multiple surgical interventions by multidisciplinary teams (plastic surgery; ear, nose, and throat specialist (ENT); maxillofacial surgery; and ophthalmology), experiencing periods of a severe, life-threatening general condition, necessitating prolonged orotracheal intubation. Wounds with fluctuating progression, extensive skin necrosis, and significant post-excisional soft tissue defects required skin graft coverage. The result meant a saved life and functional and aesthetic sequelae at the level of the face. (4) Conclusions: Necrotizing fasciitis of the face is a rare and severe disease that must be recognized early and treated appropriately by a multidisciplinary team to save the patient’s life and minimize the resulting functional and aesthetic sequelae.
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spelling doaj-art-9d83c9385f1e4b0181674df078bfe9bb2024-12-27T14:29:52ZengMDPI AGInfectious Disease Reports2036-74492024-11-011661045105410.3390/idr16060084Multidisciplinary Approach in Rare, Fulminant-Progressing, and Life-Threatening Facial Necrotizing FasciitisMihaela Pertea0Stefana Luca1Raluca Tatar2Bogdan Huzum3Mihai Ciofu4Vladimir Poroch5Dragos Octavian Palade6Daniela Vrinceanu7Mihail Balan8Oxana Madalina Grosu9Department Plastic Surgery and Reconstructive, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment Plastic Surgery and Reconstructive, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Surgery II, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Palliative Care, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Surgery II, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaENT Department, Emergency University Hospital, 050098 Bucharest, RomaniaFaculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment Plastic Surgery and Reconstructive, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania(1) Background: Necrotizing fasciitis is known as a severe condition with a high risk of mortality, placing it among the most feared infections. In most cases, it has a polymicrobial etiology (type 1), requiring complex treatment that is continuously adapted to the evolving microbiological status. The facial localization of the disease is rare, fulminant progressing, and is often life-threatening. (2) Methods: We present the case of a patient with multiple comorbidities who, following trauma to the nasal dorsum, developed a wound with a rapid and severe progression to extensive bilateral periorbital necrosis. This was accompanied by a dramatic deterioration in their general condition, a polymicrobial biological status, and fluctuating progression despite instituted treatment (both medical and surgical). (3) Results: The patient required multiple surgical interventions by multidisciplinary teams (plastic surgery; ear, nose, and throat specialist (ENT); maxillofacial surgery; and ophthalmology), experiencing periods of a severe, life-threatening general condition, necessitating prolonged orotracheal intubation. Wounds with fluctuating progression, extensive skin necrosis, and significant post-excisional soft tissue defects required skin graft coverage. The result meant a saved life and functional and aesthetic sequelae at the level of the face. (4) Conclusions: Necrotizing fasciitis of the face is a rare and severe disease that must be recognized early and treated appropriately by a multidisciplinary team to save the patient’s life and minimize the resulting functional and aesthetic sequelae.https://www.mdpi.com/2036-7449/16/6/84facial traumanecrotizing fasciitisfulminant progressiondebridationreconstructions
spellingShingle Mihaela Pertea
Stefana Luca
Raluca Tatar
Bogdan Huzum
Mihai Ciofu
Vladimir Poroch
Dragos Octavian Palade
Daniela Vrinceanu
Mihail Balan
Oxana Madalina Grosu
Multidisciplinary Approach in Rare, Fulminant-Progressing, and Life-Threatening Facial Necrotizing Fasciitis
Infectious Disease Reports
facial trauma
necrotizing fasciitis
fulminant progression
debridation
reconstructions
title Multidisciplinary Approach in Rare, Fulminant-Progressing, and Life-Threatening Facial Necrotizing Fasciitis
title_full Multidisciplinary Approach in Rare, Fulminant-Progressing, and Life-Threatening Facial Necrotizing Fasciitis
title_fullStr Multidisciplinary Approach in Rare, Fulminant-Progressing, and Life-Threatening Facial Necrotizing Fasciitis
title_full_unstemmed Multidisciplinary Approach in Rare, Fulminant-Progressing, and Life-Threatening Facial Necrotizing Fasciitis
title_short Multidisciplinary Approach in Rare, Fulminant-Progressing, and Life-Threatening Facial Necrotizing Fasciitis
title_sort multidisciplinary approach in rare fulminant progressing and life threatening facial necrotizing fasciitis
topic facial trauma
necrotizing fasciitis
fulminant progression
debridation
reconstructions
url https://www.mdpi.com/2036-7449/16/6/84
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