Cervical necrotizing fasciitis: An unusual sequel of odontogenic infection

ABSTRACT

Cervical necrotizing fasciitis is a rare infection of the fascial planes, which is less common in head and neck, becauseof the rarity and higher vascularity in the region. We reviewed five patients with cervical necrotizing fasciitisof odontogenic infection managed at a teaching hospital at Chennai, India. There were four men and one woman,of whom four patients were diabetic and hypertensive, with a mean age of 53 years. Mandibular molars (periapicalor pericoronal abscess) were found to be the source of infection in all of the cases. The treatment involved incisionand drainage and debridement. Anti-microbial drugs were given for all the patients, which included cephalosporins,metronidazole and gentamycin. In four patients the wound healed by contracture and one patient required split skingrafting. Due to the smaller extent of the necrosis, better control of the systemic disease and small size of the sample,there was neither a major complication nor death. This paper reminds us that cervicofacial necrotizing fasciitis(CNF) remains one of the potential complications of long standing odontogenic infections in patients with immunecompromisedstatus, particularly in lower dentition (AU)