Necrotizing fasciitis of odontogenic origin in Ibadan, Nigeria

We reviewed eight patients with necrotizing fasciitis of odontogenic origin. There were three women and five men, mean age 58 (range 46-72), and none had any associated medical condition such as diabetes. All cases had symptoms of toothache for a mean duration of 34 days (range 26-42) before they sought treatment. Infection originated in the molar teeth region, and initially presented as an odontogenic or periodontal abscess. The clinical features of necrotizing fasciitis became apparent only after the superficial fascia had been invaded. The transient unusually reddish hue for a dark skin might be explained by the fact the deep fascia and muscles were affected before the superficial fascia and skin. Necrosis of the skin began in the submandibular region and progressed downwards. The necrotic area was less than the extent of infection. Antimicrobial treatment, debridement, and fasciotomy improved healing. Delay before appropriate treatment had an adverse affect on outcome, and one patient died.