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OBJECTIVE: This study aimed to present the clinical features, microbiological patterns of odontogenic infection and treatment outcome associated with cases of Cervicofacial necrotizing fasciitis (CNF) seen in a South-South Nigerian population.
METHODS: A 6-year retrospective review of patients diagnosed of CNF. The data analyzed were patients’ age, gender, site of infection, implicated tooth, co-morbid conditions, microbiology profile, treatment modalities, length of stay in the hospital, treatment outcome and possible cause of death.
RESULTS: There were 6 patients diagnosed of CNF during the period of study, consisting of 2 (33.3%) males and 4 (66.7%) females, giving a ratio of 1:2. The patients’ mean age was 59.5 + 7.9 years (SEM) and 5 (83.3%) patients presented with associated medical conditions, among which 2 (33.3%) patients each had
diabetes mellitus, hypertension and jaundice. Acute apical periodontitis was the most common odontogenic infection and the second mandibular tooth was the most frequently affected tooth type (n=4, 66.7%). All the patients presented with infected facial space swelling especially the submandibular space. Most of the patients had mixed bacterial infection, with peptostreptococcus sp and klesiella sp occurring in 2(33.3%) patients each. Most patients’ (n=4, 66.7%) treatment included exodontia of infected tooth, fasciotomy, debridement, twice daily dressings and antimicrobial therapy. The mortality rate was 50%, with 3 patients, death resulting from septic shock (n=2, 33.3%) and thromboembolism (n=1, 16.7).
CONCLUSION: CNF in the head and neck region mimics facial space infections. A high index of suspicion is needed for prompt management of CNF. Mortality can thus be reduced by early diagnosis and treatment of the patients.