Cervical Necrotizing Fasciitis: A Potentially Fatal Disease with Varied Etiology

Necrotizing fasciitis was recognized centuries ago by physicians. It is a rapidly progressive and potentially fatal soft-tissue infection that is typified by soft-tissue necrosis, especially affecting the subcutaneous tissues and fascia. Cervico-facial necrotizing fasciitis is said to be uncommon, but when it occurs, it is often of odontogenic origin and has severe consequences if not promptly treated. Possible underlying systemic diseases and the source of infection should be addressed and treated appropriately. We present two cases of extensive cervicofacial necrotizing fasciitis, one of which was idiopathic in origin and the other with gross involvement of the chest and abdominal walls. Both were treated successfully. Immediate resuscitation of the patients, administration of empirical antibiotics, treatment of underlying systemic conditions and early, aggressive and serial debridement were the bedrock of management in these cases.