Extensive cervical necrotizing fasciitis of odontogenic origin.
Necrotizing fasciitis (NF) is an uncommon infection, but potentially lethal, especially when associated with systemic disorders such as diabetes. The authors report a case of necrotizing fasciitis from odontogenic origin in a patient with uncontrolled diabetes mellitus. The initial diagnosis was based on clinical information, in which multiple necrosis areas in cervical and thoracic regions were observed. Wide antibiotic therapy was applied, followed by surgical drain age and debridement. Culture was positive for methicillin-resistant Staphylococcus aureus. Although the treatment is established, the patient dies after sepsis and failure of vital organs. Clearly, the morbidity associated to this infection, even in diabetic patients, can be minimized if an early diagnosis and effective debridement are done.
From the *Department of Oral and Maxillofacial Surgery and Periodontology (USP) and Department of Oral and Maxillofacial Surgery, Universidade de Pernambuco, Recife; †Department of Oral and Maxillofacial Surgery (PUCRS), Universidade de Pernambuco, Recife; ‡Surgery & Integrated Clinic Department, Araçatuba Dental School, São Paulo State University, São Paulo; §Oral & Maxillofacial Surgery Department, Piracicaba Dental School, Campinas State University, São Paulo; and ∥Oswaldo Cruz Hospital, São Paulo, Brazil.
Antonio Azoubel
AA
Antunes
Rafael Linard
RL
Avelar
Willian Morais
WM
de Melo
Darklilson
D
Pereira-Santos
Riedel
R
Frota
D003646:Debridement; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D019115:Fasciitis, Necrotizing / Q000382:microbiology* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D005491:Focal Infection, Dental / Q000382:microbiology*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000502:physiology*; D008875:Middle Aged; D009102:Multiple Organ Failure; D009333:Neck / Q000601:surgery; D018805:Sepsis / Q000382:microbiology; D013203:Staphylococcal Infections / Q000382:microbiology*; D014081:Tooth Extraction / Q000009:adverse effects*