Publication/Presentation Date
2-1-2022
Abstract
Necrotizing fasciitis is a life-threatening infection that can be rapidly fatal. Early identification and emergent surgical management are essential to minimize morbidity and mortality. This case report describes a 25-year-old male who presented to the emergency department with a three-day history of worsening left lower dental infection and new-onset neck pain and swelling. He received broad-spectrum antibiotics and intravenous fluid resuscitation and underwent computed tomography of the neck and chest. Following intensive care unit admission, he underwent tooth extraction where intraoperative evaluation revealed subcutaneous crepitus. Immediate debridement was performed, revealing copious foul-smelling purulent discharge and necrotic tissue extending over the anterior chest wall and neck. During his hospital course, he underwent multiple debridements to manage the expanding infection. The final tissue defect was substantial, with deep dissection to muscle extending over the entire anterior surface of the rib cage to just inferior to the clavicles. This significant tissue defect was managed with skin grafts, and he was discharged home in stable condition. The patient is doing well almost a year after discharge. The key to our patient's survival was the early identification and debridement of the affected tissue. Our study reinforces the tenants of wound care and aggressive management required to bolster patient odds of survival in the setting of necrotizing fasciitis and underscores the importance of maintaining vigilance in patients presenting with dental infections. This study is unique in that our patient was young, with a past medical history significant for polydrug use, and the area of debridement was substantial.
Volume
14
Issue
2
First Page
22438
Last Page
22438
ISSN
2168-8184
Published In/Presented At
Huff ML, Wilson KS, Kane KE, Wheel KL, Stirparo JJ. A Severe Case of Odontogenic Infection and Necrotizing Fasciitis of the Anterior Chest Wall and Neck. Cureus. 2022;14(2):e22438. Published 2022 Feb 21. doi:10.7759/cureus.22438
Disciplines
Medicine and Health Sciences
PubMedID
35371740
Department(s)
Department of Emergency Medicine, Department of Surgery, Fellows and Residents, USF-LVHN SELECT Program
Document Type
Article
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.