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Odontogenic Infection Complicated by Cervicofacial Necrotizing Fasciitis in a Healthy Young Female

Necrotizing fasciitis (NF) is a critical and rapidly progressive infection of the skin and soft tissue, and it is associated with a high mortality rate. NF of the cervicofacial region is uncommon due to the rich vascular supply of the head and neck, which promotes an efficient immune response to inf...

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Autores principales: Cecchini, Amanda, Cox, Cody J, Cecchini, Arthur A, Solanki, Krupa, McSharry, Roger
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8409800/
https://www.ncbi.nlm.nih.gov/pubmed/34513425
http://dx.doi.org/10.7759/cureus.16835
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author Cecchini, Amanda
Cox, Cody J
Cecchini, Arthur A
Solanki, Krupa
McSharry, Roger
author_facet Cecchini, Amanda
Cox, Cody J
Cecchini, Arthur A
Solanki, Krupa
McSharry, Roger
author_sort Cecchini, Amanda
collection PubMed
description Necrotizing fasciitis (NF) is a critical and rapidly progressive infection of the skin and soft tissue, and it is associated with a high mortality rate. NF of the cervicofacial region is uncommon due to the rich vascular supply of the head and neck, which promotes an efficient immune response to infection. Patients who are immunocompromised or have comorbidities affecting the vasculature, such as diabetes mellitus or peripheral vascular disease, are at an increased risk of more severe disease and outcome. Cervicofacial necrotizing fasciitis (CNF) is most frequently attributed to mucosal damage, such as those related to dental infections or local trauma including medical procedures. Due to its ability to quickly spread to the neck and mediastinum, CNF must be diagnosed and treated expeditiously. In this report, we present a case of a 28-year-old female with a past medical history significant for obesity and tobacco abuse who presented to the emergency department (ED) with fever, left-sided facial pain, cervical pain, and swelling. She had worsening symptoms despite current treatment with clindamycin for a dental abscess. A CT scan of the head and neck revealed an odontogenic abscess complicated by CNF. Intravenous antibiotics were initiated and she underwent prompt surgical intervention. She remained nasally intubated following her surgery due to concern for postoperative edema leading to airway compromise. Following extubation, she experienced an uncomplicated recovery. This case demonstrates that NF is a complication of dental infection that may occur even in young and relatively healthy patients. Additionally, due to the swiftly destructive nature and high mortality rate of CNF, early diagnosis and aggressive medical and surgical therapy are essential to reduce morbidity and mortality.
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spelling pubmed-84098002021-09-09 Odontogenic Infection Complicated by Cervicofacial Necrotizing Fasciitis in a Healthy Young Female Cecchini, Amanda Cox, Cody J Cecchini, Arthur A Solanki, Krupa McSharry, Roger Cureus Emergency Medicine Necrotizing fasciitis (NF) is a critical and rapidly progressive infection of the skin and soft tissue, and it is associated with a high mortality rate. NF of the cervicofacial region is uncommon due to the rich vascular supply of the head and neck, which promotes an efficient immune response to infection. Patients who are immunocompromised or have comorbidities affecting the vasculature, such as diabetes mellitus or peripheral vascular disease, are at an increased risk of more severe disease and outcome. Cervicofacial necrotizing fasciitis (CNF) is most frequently attributed to mucosal damage, such as those related to dental infections or local trauma including medical procedures. Due to its ability to quickly spread to the neck and mediastinum, CNF must be diagnosed and treated expeditiously. In this report, we present a case of a 28-year-old female with a past medical history significant for obesity and tobacco abuse who presented to the emergency department (ED) with fever, left-sided facial pain, cervical pain, and swelling. She had worsening symptoms despite current treatment with clindamycin for a dental abscess. A CT scan of the head and neck revealed an odontogenic abscess complicated by CNF. Intravenous antibiotics were initiated and she underwent prompt surgical intervention. She remained nasally intubated following her surgery due to concern for postoperative edema leading to airway compromise. Following extubation, she experienced an uncomplicated recovery. This case demonstrates that NF is a complication of dental infection that may occur even in young and relatively healthy patients. Additionally, due to the swiftly destructive nature and high mortality rate of CNF, early diagnosis and aggressive medical and surgical therapy are essential to reduce morbidity and mortality. Cureus 2021-08-02 /pmc/articles/PMC8409800/ /pubmed/34513425 http://dx.doi.org/10.7759/cureus.16835 Text en Copyright © 2021, Cecchini et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Cecchini, Amanda
Cox, Cody J
Cecchini, Arthur A
Solanki, Krupa
McSharry, Roger
Odontogenic Infection Complicated by Cervicofacial Necrotizing Fasciitis in a Healthy Young Female
title Odontogenic Infection Complicated by Cervicofacial Necrotizing Fasciitis in a Healthy Young Female
title_full Odontogenic Infection Complicated by Cervicofacial Necrotizing Fasciitis in a Healthy Young Female
title_fullStr Odontogenic Infection Complicated by Cervicofacial Necrotizing Fasciitis in a Healthy Young Female
title_full_unstemmed Odontogenic Infection Complicated by Cervicofacial Necrotizing Fasciitis in a Healthy Young Female
title_short Odontogenic Infection Complicated by Cervicofacial Necrotizing Fasciitis in a Healthy Young Female
title_sort odontogenic infection complicated by cervicofacial necrotizing fasciitis in a healthy young female
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8409800/
https://www.ncbi.nlm.nih.gov/pubmed/34513425
http://dx.doi.org/10.7759/cureus.16835
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