Clinical characteristics and management of odontogenic necrotizing fasciitis: a retrospective study

Abstract

Background: Life-threatening illnesses like necrotizing fasciitis (NF) from dental origin arise suddenly and unexpectedly as a result of the debilitating condition and frequent self-medicating behaviour. This article aims to report the medical and therapeutic characteristics of 15 patients while discussing risk factors, pathogenetic mechanisms and management of this disease. Method: From 2012 up to 2022, a retrospective chart study of patients with odontogenic NF was carried out. Demographic, medical and therapeutic data were collected and analysed, using the Excel program. Results: Fifteen patients were identified with retrievable medical records. There was a male predominance, and the age ranged from 13 to 82 years with a majority over 40 years. Preadmission delay was ≤4 days in 40% of patients with self-medication of non-steroid anti-inflammatory drugs. 53.85% of patients had previous dental treatment without antibiotic coverage. Rheumatoid arthritis was the predominant comorbidity followed by diabetes mellitus and anaemia. Multispace involvement was found in 73.33% of patients. Preoperative computed tomography was performed for 60% of patients. Conclusion: Prompt and efficient treatment is required for NF, a polymicrobial odontogenic infection that is lethal even in healthy people. Self-medication and debilitating condition should be considered. Early diagnosis and therapy may reduce mortality and morbidity.