Necrotizing fasciitis caused by dental infection: a retrospective analysis of 9 cases and a review of the literature

Abstracts on both these pages have been chosen and edited by Dr Trevor Watts

Abstract

This potentially fatal dental complication may be resolved with aggressive treatment.

Main

Umeda M, Minamikawa T et al. Oral Surg 2003; 95: 283–290

This study reviewed 125 reported cases and 9 new cases of the condition. Of these 9, 2 cases were associated with diabetes, and one of these had other systemic problems. All cases were confirmed by gas bubbles in the CT scan. Treatment was with multiple antibiotics and surgical debridement within 24 hrs, 4 patients were given tracheostomy, and the outcome was satisfactory in all cases. Inpatient care continued for 18–46 days.

Review of the 125 reported cases showed 20% mortality, particularly when there were systemic complicating factors or delay of surgery. The authors noted that a history of diabetes or alcohol abuse, or the complication of mediastinitis, was associated with mortality. They consider that treatment success depends on early diagnosis and prompt, thorough surgical treatment.