{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T20:57:09Z","timestamp":1784667429100,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2006,7,18]],"date-time":"2006-07-18T00:00:00Z","timestamp":1153180800000},"content-version":"vor","delay-in-days":4035,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[1995,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Background.<\/jats:italic> Craniocervical necrotizing fasciitis (CCNF) is a rapidly progressive, severe bacterial infection of the superficial fascial planes of the head and neck. Group A beta\u2013hemolytic <jats:italic>Streptococcus, staphylococcus aureus<\/jats:italic>, and obligate anaerobic bacteria are common pathogens. The disease usually results from a dental source or facial trauma. Extensive fascial necrosis and severe systemic toxicity are common manifestations of CCNF. Recently the lay press has referred to necrotizing fasciitis in several articles about \u201cflesh eating\u201d bacteria, which have resulted in several deaths.<\/jats:p><jats:p><jats:italic>Methods.<\/jats:italic> We report the first case of a fatality in an otherwise immunocompetent patient. The patient was a 66\u2010year\u2010old black man with no identifiable source of infection and no history or evidence of immunocompromising disorders.<\/jats:p><jats:p><jats:italic>Results.<\/jats:italic> Despite aggressive surgical debridement and broad\u2010spectrum antibiotic coverage, he died 30 hours after admission from multisystem organ failure secondary to overwhelming sepsis.<\/jats:p><jats:p><jats:italic>Conclusion.<\/jats:italic> Treatment consists of early recognition of CCNF combined with aggressive surgical debridement and drainage of the involved necrotic fascia and tissue along with broad\u2010spectrum intravenous antibiotic coverage. Although 11 other fatal cases of CCNF have been previously reported, all had an underlying medical problem which created an immunocompromised state, usually diabetes mellitus or chronic alcoholism. We present a case report and literature review along with a discussion of the related anatomy. \u00a9 1995 Jons Wiley &amp; Sons, Inc.<\/jats:p>","DOI":"10.1002\/hed.2880170414","type":"journal-article","created":{"date-parts":[[2007,2,21]],"date-time":"2007-02-21T22:40:42Z","timestamp":1172097642000},"page":"351-357","source":"Crossref","is-referenced-by-count":24,"title":["Fatal craniocervical necrotizing fasciitis in an immunocompetent patient: A case report and literature review"],"prefix":"10.1002","volume":"17","author":[{"given":"Douglas E.","family":"Henrich","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy L.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William W.","family":"Shockley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,7,18]]},"reference":[{"key":"e_1_2_1_2_2","volume-title":"Surgical memories of the War of Rebellion","author":"Jones J","year":"1871"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1924.01120080083007"},{"key":"e_1_2_1_4_2","first-page":"416","article-title":"Necrotizing fasciitis","volume":"18","author":"Wilson B","year":"1952","journal-title":"Am Surg"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0278-2391(88)90410-7"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198412000-00008"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1992.tb01010.x"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-197607000-00013"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800620510"},{"key":"e_1_2_1_10_2","first-page":"738","volume-title":"Head and neck surgery\u2013otolaryngology","author":"Scott BA","year":"1993"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/019459988409200303"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/019459989210600404"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(77)90283-5"},{"key":"e_1_2_1_14_2","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1128\/jb.74.5.673-679.1957","article-title":"Studies on the toxic cellular component of group A streptococci","volume":"74","author":"Schwab JH","year":"1957","journal-title":"J Bacteriol"},{"key":"e_1_2_1_15_2","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1128\/jb.90.5.1412-1419.1965","article-title":"Biological properties of streptococcal cell wall particles: II purification by density gradient column electrophoresis","volume":"90","author":"Schwab JH","year":"1965","journal-title":"J Bacteriol"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1084\/jem.116.1.17"},{"key":"e_1_2_1_17_2","first-page":"813","article-title":"Streptococcal necrotizing fasciitis: development of an animal model to study its pathogenesis","volume":"69","author":"Seal DV","year":"1988","journal-title":"Br J Path"},{"key":"e_1_2_1_18_2","first-page":"347","article-title":"Hyperbaric oxygen management of chronic staphylococcal osteomyelitis of the temporal bone","volume":"11","author":"Schweitzer VG","year":"1990","journal-title":"Am J Otol"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1980.00790340056015"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197205000-00010"},{"key":"e_1_2_1_21_2","first-page":"88","article-title":"Gangrene of the eyelids","volume":"5","author":"Ross J","year":"1973","journal-title":"Ann Ophth"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(73)90207-7"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196503182721109"},{"key":"e_1_2_1_24_2","first-page":"525","article-title":"Fatal necrotizing fasciitis developing after tooth extraction","volume":"39","author":"Crowson WN","year":"1973","journal-title":"Am Surg"},{"key":"e_1_2_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0278-2391(89)90192-4"}],"container-title":["Head &amp; 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