Characteristics of Cervical Necrotizing Fasciitis (CNF) Patient in Oral and Maxillofacial Surgery Department Rsup Dr Hasan Sadikin: 2 Years Retrospective Study

Abstract

Cervical necrotizing fasciitis (CNF) is a life-threatening bacterial infection that runs aggressively in the subcutaneous tissue and fascia in the head and neck area with clinical presentation of extensive necrotic tissue that develops from infection of the teeth or gingiva and other supporting tissues accompanied by an endosteal or periosteal infection of the jaw. This research aims to obtain information about characteristic patients with cervical necrotizing fasciitis (CNF). This study is an observational study with a retrospective descriptive approach. Based on medical record data, the research was conducted at Hasan Sadikin General Hospital (RSHS) Bandung from March 2019 – March 2021. The data collected include age, gender, onset, nutritional status, region, clinical diagnosis, microbiology, antibiotic sensitivity resistance, length of stay, and source focal infection. In this study, 23 medical records were obtained. The most frequent characteristics of the subjects were elderly aged more than 50 years (47.8%) and males (61%). The most frequent locations were the submandible area (100%), and the most frequent source of focal infection was from mandibular posterior teeth (60.46%). From the onset to the symptoms frequently 7-14 days with the nutritional status, most patients were malnourished (58%). Regarding microbiology gram negative dominantly (66,6%), with the most bacterial that worsening the spread of CNF being Acinobacter Baumanii (26.0%), Tigecycline becomes antibiotic most sensitive (43,47%), Cefazoline is the most resistance (73.91%). Most patients were treated by surgery necrotomy debridement (95, 6 %), and most improved (76 %). The ability to diagnose quickly and take aggressive action is needed to treat patients with Cervical Necrotizing Fasciitis (CNF) because of its high progression.