Necrotizing fasciitis of the cervico-facial region due to odontogenic infection

Necrotizing fasciitis (NF) of cervical region is an uncommon sequelae of odontogenic infection. It has been described in the past with different names such as hospital gangrene, necrotizing erysipelas, haemolytic streptococcal gangrene, suppurative fasciitis, bacterial synergistic gangrene and acute dermal gangrene [1] and [2].It is a highly aggressive infectious process characterized by spread along the fascial planes. It can rapidly involve overlying skin, subcutaneous tissues, muscle, and other adjacent soft tissue structures. The most frequently involved areas are the thorax, limbs, perineum, abdomen, and groin [3] and [4]. Occurrence in the head and neck region is relatively rare.The most common causes of cervical necrotizing fasciitis are odontogenic infection, blunt trauma, radiotherapy, and necrotizing fasciitis of unknown origin. It is a debilitating condition, with a high mortality rate and poor prognosis is aggravated with development of mediastinitis and septic shock.The predisposing factors include diabetes mellitus, steroid administration, arteriosclerosis, chronic renal failure, hypothyroidism, obesity, alcoholism, cancer, cirrhosis, drug abuse, and a poor nutritional state, as it involves suppression of host defence mechanism. We present two cases of NF, originating from odontogenic infection, successfully managed in our department.