Clinical ArticlesCervical necrotizing fasciitis of odontogenic origin: A case report and review of 12 cases☆,☆☆,☆,☆☆
Section snippets
Report of case
A 46-year-old HIV-positive woman, with a history of hypertension, presented to the emergency department of University of Maryland Medical System in April 1997 with the complaint of increasing pain and swelling for the previous 3 days. She had seen a dentist in the community earlier in the week for a painful lower molar and was treated with penicillin.
Physical examination showed an obese woman with moderate to severe edema of the sublingual, submandibular, and submental spaces, causing
Review of cases
A retrospective review was conducted for the charts of adult patients with NF of the head and neck admitted to the R. Adams Cowley Shock Trauma Center or the University of Maryland Medical System between 1987 and 1997. Twenty-five charts meeting this criterion were collected. Eleven patients had documented cervical NF of odontogenic origin; the other 14 had cervical NF from a nonodontogenic source. Children were not considered for this study because cervical NF in the pediatric population
Discussion
Patients with cervical NF typically are febrile, with elevated WBC counts (as were 80% of the patients in this series). They also tend to be dehydrated and malnourished secondary to poor oral intake during the course of their disease.2, 4, 6, 12 Hypocalcemia is frequently present secondary to necrosis of fat and may be demonstrated clinically with neuromuscular excitability and positive Chvostek's and Trousseau's signs.2, 4
Risk factors for the development of NF include diabetes mellitus,
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Cited by (94)
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2022, International Journal of Surgery Case ReportsCitation Excerpt :Cellulitis of dental origin (CDO) is a polymicrobial infection of soft and fat tissue next to the mandible and maxilla [1,2].
Ludwig's angina: A diagnostic and surgical priority
2020, International Journal of Infectious DiseasesNecrotizing fasciitis of the entire head and neck: Literature review and case report
2020, Biomedical JournalCitation Excerpt :Infection of second and third molars of the mandible are the most frequent aetiologies of odontogenic cervical NF [5]. Wong's study also indicated the lower molars are the most common regions [6], and Whitesides et al. revealed up to 81% of patients with cervical NF were originated from second and third molar infections [7]. These teeth deepen into the mylohyoid insertion over the lingual side of the mandible.
Odontogenic infection progressing to necrotizing fasciitis: An unusual clinical emergence
2019, Oral and Maxillofacial Surgery Cases
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*Formerly, Resident; Currently, Private Practice, Marietta, GA.
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†Co-director.
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‡Director.
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Address correspondence and reprint requests to Dr Myers: Hyperbaric Medicine, R. Adams Cowley Shock Trauma Center, University of Maryland Medical System, 22 S Greene St, Baltimore, MD 21201.