Abstract

PILLAY, N  and  MHLANGA, G. Cervical Necrotizing Fasciitis: A case report. S. Afr. dent. j. [online]. 2022, vol.77, n.9, pp.559-562. ISSN 0375-1562.  http://dx.doi.org/10.17159/2519-0105/2022/v77no9a5.

Necrotizing fasciitis is a rare but rapidly progressive condition, with a high morbidity and mortality rate. This rapidly spreading soft tissue infection rarely occurs in the head and neck region, and when it does it is most caused by odontogenic origin. A variety of host factors such as immune status, hygienic practices and socio-economic status are role players in the disease process. This case report documents a 38-year old male who presented with cervical necrotizing fasciitis of odontogenic origin. The patient was managed and stabilized through removal of the necrotic tissue, extraction of all carious teeth, and optimization of the overall medical health status of the patient. HIV is widely prevalent in South Africa and therefore the patient consented to HIV testing, this alluded to an undiagnosed HIV positive status. Uncontrolled HIV greatly suppresses the immune system and subsequently exacerbating the disease process thus its management is highlighted below. The patent is currently awaiting reconstructive plastic surgery which can only be addressed once his viral load is controlled. In the meantime, he has been educated on how to keep the wound clean and the importance of maintaining a healthy lifestyle, this includes HIV education and dietary information. Due to the poor prognosis often associated with necrotizing fasciitis, it requires early intervention, and a multidisciplinary approach is often needed.

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