Odontogenic Submandibular and Descending Necrotising Fasciitis or Myositis – A Case Report on a Clinical Dilemma

Abstract

The Rationale: Odontogenic space infection has the potential to spread uncontrollably into adjoining fascial spaces. Prompt diagnosis and management are mandatory to prevent gross morbidity and death. Patient Concerns: We present a case report of odontogenic origin-submandibular necrotising fasciitis and myositis in a lactating female. Diagnosis: Computed tomography scan revealed an ill-defined fluid collection with air foci within it in the left submandibular region with evidence of extension along the left sternocleidomastoid and along the strap muscles of the neck. Histopathology of the necrotic tissue confirmed necrotising fasciitis. Treatment: Extensive surgical debridement and tooth extraction of left mandibular second molar under antibiotic cover. Outcomes: Uneventful post-surgical wound healing and general medical condition of the mother and child were satisfactory at 13th-month follow-up. Take- Away Lessons: Prompt diagnosis and management of odontogenic fascial space infection in a lactating mother to prevent the spread of infection in both lactating mother and the child.