Necrotizing fasciitis caused by dental infection: a retrospective analysis of 9 cases and a review of the literature.
OBJECTIVE
Necrotizing fasciitis of the head and neck is an uncommon, potentially fatal soft tissue infection characterized by extensive necrosis and gas formation in the subcutaneous tissue and fascia. The aims of this study were to describe the condition of this rare disease and to find factors affecting the mortality.


METHODS
Nine of our new cases and 125 reported cases in the English-language literature with necrotizing fasciitis of dental origin were reviewed.


RESULTS
Two of our 9 patients had some form of systemic disease such as diabetes, cardiac insufficiency, renal failure, or cerebral infarction, whereas the other 7 had no particular general complications. A computed tomography examination was useful for detecting gas formation in the deep neck. All 9 patients underwent extensive debridement within 24 hours, and good results were obtained. In contrast, 24 of the 125 reviewed patients died despite therapy. Factors affecting the mortality were associated diseases such as diabetes or alcohol abuse, delay of surgery, and the complication mediastinitis.


CONCLUSIONS
Necrotizing fasciitis is still a potentially fatal disease. Early and aggressive debridement may reduce mortality.
Umeda
Masahiro
M
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kobe University. ume@med.kobe-u.ac.jp
Minamikawa
Tsutomu
T
Komatsubara
Hideki
H
Shibuya
Yasuyuki
Y
Yokoo
Satoshi
S
Komori
Takahide
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D003646:Debridement; D019115:Fasciitis, Necrotizing / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005260:Female; D005491:Focal Infection, Dental / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed
D002097:C-Reactive Protein