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Case Report

Emergency Management of Necrotizing Fasciitis at Left Submandible Region Due to Odontogenic Infection: A Case Report

Agnesthesia Ruth Stevhany, Eka Marwansyah Olii, Agus Nurwiadh.

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Introduction: Necrotizing fasciitis (NF)-infection of soft tissues that results in the destruction of fascia and soft tissues. Infections that occur in the region of the head and neck, in most cases the aetiology is odontogenic.
Objective: Early diagnosis coupled with emergent necrotomy debridement, appropriate broad-spectrum empiric antibiotic treatment, and a multidisciplinary team approach is essential for successful treatment.
Case: We reported a 61-year-old male patient who came with swelling in the cheek, left lower jaw, chin, neck region and there was necrotic tissue at the left submandible region. He was diagnosed with necrotizing fasciitis at the left submandible region with left submandible abscess extended to left buccal, submental, right submandible, Colli anterior, and bilateral hemithorax region and we found multiple radices that were thought to be the source of infection.
Case Management: The principles of early diagnosis, incision and drainage, extraction of teeth, extensive necrotomy debridement, broad-spectrum antibiotic therapy, and intensive supportive care in the treatment of NF were confirmed in the present case.
Conclusion: The reduction of mortality of this disease depends upon early detection, and early and adequate necrotomy debridement treatment. Delays in surgical intervention >14 hours are associated with significantly higher mortality, septic shock, and more repeat debridement.

Key words: Debridement, Necrotizing fasciitis, Odontogenic infection

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