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. 2024 Dec;76(6):5857-5860.
doi: 10.1007/s12070-024-04919-x. Epub 2024 Aug 1.

Odontogenic Actinomycotic Necrotizing Fasciitis of Cervicothoracic Region: A Case Report

Glynis Francis  1 , K Vigneswaran  1 , S Gokul  1 , Charisha David  1 , Rajarajeswari Nalamate  1 , N Vasanthi  2 , Sithanandakumar Venkatesan  1
Affiliations

Odontogenic Actinomycotic Necrotizing Fasciitis of Cervicothoracic Region: A Case Report

Glynis Francis et al. Indian J Otolaryngol Head Neck Surg. 2024 Dec.

Abstract

We report an uncommon odontogenic actinomycotic cervicothoracic Nectrotizing Fasciitis (NF), treated with tracheostomy, immediate surgical debridement and antibiotics. Red flags for early identification, LRINEC scoring for prognostication, surgical debridement with aerobic & anaerobic culture specific antibiotics to improve survival in this life-threatening cervicothoracic NF in a young diabetic is discussed.

Keywords: Actinomycosis; Cervicothoracic; Necrotizing fasciitis; Tracheostomy.

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Figures

Fig. 1
Fig. 1
CECT neck, chest- 4.4 × 5.3 × 6.6 cm ill-defined non-enhancing hypodense collection with multiple air pockets in submandibular region infiltrating left mylohyoid, overlying skin, extending to anterior chest wall, tracking along anterior triangle of neck upto thyroid gland, infiltrating sternomastoid, thyrohyoid and sternohyoid muscles, parasymphysial aspect of mandible, suggestive of myofascitis
Fig. 2
Fig. 2
Pre-operative appearance, tracheostomy, surgical debridement, twice daily dressing with Povidone Iodine and Hydrogen-peroxide irrigation, followed by local metronidazole wash. By seventh-day healthy granulation was noted. Patient decannulated on POD 10 oral antibiotics for 2 weeks, healed neck
See this image and copyright information in PMC

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