Nonodontogenic Cervical Necrotizing Fasciitis Caused by Sialadenitis.

Abstract

The term necrotizing fasciitis was described initially by Wilson in the 1950s [1]. Necrotizing fasciitis is a rapid spreading disease of the soft tissue, which includes the superficial fascia and subcutaneous layer of tissue [2–4]. Necrotizing fasciitis is associated with some situations in which the immune system is compromised, including diabetes mellitus (DM), elderly, acute, or chronic renal disease, postpartum period, alcoholism, intravenous (IV) drug use, malnutrition, malignancy, peripheral vascular disease, and radiation exposure [5]. Necrotizing fasciitis diagnosis is based on certain clinical features that include fulminant progression, presence of greyblack necrotic area, and easy separation of the superficial layers of the underlying tissue [2, 6]. Necrotizing fasciitis can emerge from a local infection region after a minor trauma, which leads to the entrance of site of the infection. The exact etiology of one-third of the necrotizing fasciitis patients is not clear [2, 3, 6]. If necrotizing fasciitis is not diagnosed and treated early, it is potentially a fatal disease [4, 7, 8]. This situation is based on the absence of early clinical findings, rapid progression of the disease, and the delay of surgical intervention [9]. Therefore, experience in the diagnosis and treatment of necrotizing fasciitis is quite limited. Involvement of the head and neck region is quite rare for necrotizing fasciitis patients [2]. In this region there are two types of necrotizing fasciitis and they include cervical and craniofacial involvement [10]. Mortality rates of cervical necrotizing fasciitis range from 7% to 20% depending on the width of the cervical lesion [11]. This case report is presented because, unlike most of the others, this case of necrotizing fasciitis is nonodontogenic, sialoadenitis induced cervical necrotizing fasciitis.