Servical necrotizing soft tissue infection due to tooth abscess in a pregnant patient: A rare case
PDF
Cite
Share
Request
Case Reports
VOLUME: 28 ISSUE: 2
P: 102 - 105
June 2012

Servical necrotizing soft tissue infection due to tooth abscess in a pregnant patient: A rare case

Turk J Surg 2012;28(2):102-105
1. Selçuk Üniversitesi Meram Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Konya, Türkiye
No information available.
No information available
PDF
Cite
Share
Request

Abstract

Necrotizing soft tissue infections (NSTI) are life threatening infections with high rates of mortality and morbidity. In the present article we discuss cervical NSTI following a tooth abscess in a 19-year-old female patient with 24 week pregnancy in comparison with the literature on the subject. The patient with cervical abscess in the right submandibulary area following a tooth abscess underwent abscess drainage by the ear-nose-and throat surgery clinic. Because there was a bad smelling drainage from the incision from where a drainage was performed in the postoperative third hour, an occurrence of crepitation around 5 cm's of the surgical area, and the deterioration of the patient's general condition she was consulted by us and went into emergency surgery with a NSTI prediagnosis. NSTI was seen intraoperatively in the cervical area and a radical debridement was performed. The patient's tissue vitality was enabled through recurrent debridements in the postoperative period. The occurrence of NSTIs is quite rare in the cervical area. The most important reason for this is based on the fact that the area has a rich blood flow. The reason for the development of NSTIs of the cervical area is mostly dental pathologies and these are followed by parafarengeal and peritonsillar infections. We also think that the patient's pregnancy had a progressive effect on the infection. If the patient survives with radical debridement, intensive care support, and appropriate antibiotherapy, the reconstruction of the past wide defect proves to be a challenging process. Thus, NSTI treatment requires a multidisciplinary approach.

Keywords:
Cervical infection, necrotizing soft tissue infection, dental abscess, pregnancy

References

1
Wilson B. Necrotizing fasciitis. Am Surg 1952; 18:416–431.
2
Wilson HD, Haltelin KC. Acute necrotizing fasciitis in childhood. Report of cases. Am J Dis Child 1973; 125:591–595. doi:10.1001/ archpedi.1973.04160040087018
3
Özgenel GY, Akın S, Kahveci R, ve ark. Nekrotizan fasitli 30 hastanın klinik değerlendirilmesi ve tedavi sonuç-ları. Ulusal Travma ve Acil Cerrahi Dergisi 2004; 10:110–114.
4
Banerjee AR, Murty GR, Moir AA. Cervical necrotizan fasiitis: a distint clinopathological entity? Laryngol Otol 1996; 110:81–86. doi:10.1017/ S0022215100132797
5
Green RJ. Necrotizan fasciitis. Chest 1996; 110:219–229. doi:10.1378/chest.110.1.219
6
Riefler J, Molavi A, Schwartz D, et al. Necrotizing fasciitis in adults due to group B streptococcus. Report of a case review of the literature. Arch Intern Med 1988; 148:727–729. doi:10.1001/ archinte.1988.00380030233036
7
Gürlek A, Fırat C, Öztürk AE, et al. Management of necrotizan faciitis in diabetic patients. J Diabetes Complications 2007; 21:265–271. doi:10.1016/j.jdiacomp.2006.08.006
8
Poole JA, Claman HN. Immunology and pregnancy implication for the mother. Clin Rev Allergy Immunol 2004; 26:161–170. doi:10.1385/CRIAI:26:3:161
9
Tang WM, Ho PL, Fung KK, et al. Necrotizing fasciitis of a limb. J Bone Joint Surg 2001; 83:709–719. doi:10.1302/0301-620X.83B5.10987
10
Wall DB, de Virgilio C, Black S, et al. Objective criteria may assist in distinguishing necrotizing fasciitis from nonnecrotizing soft tissue infection. Am J Surg 2000; 179:17–21. doi:10.1016/S0002-9610(99)00259-7
11
Lorianni P, Oliver GC. Synergistic soft tissue infections of the perineum. Dis Colon Rectum 1992; 35:640–644.
12
Wall DB, de Virgilio C, Black S, et al. Objective criteria may assist in distinguishing necrotizing fasciitis from nonnecrotizing soft tissue infection. Am J Surg 2000; 179:17–21. doi:10.1016/ S0002-9610(99)00259-7
13
Elliott DC, Kufera JA, Myers RA. Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Ann Surg 1996; 224:672–683. doi:10.1097/00000658-199611000-00011