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Extensive Odontogenic Deep Neck Infection Complicated by Necrotizing Fasciitis and Bilateral Mastitis: A Rare Case
Adil Aytaç1, Uğur Dönmez1, Bahar Yanık Keyik1
1Department of Radiology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye, balikesir.edu.tr.
Case Reports in Surgery
|April 24, 2026
Summary
Odontogenic infections can spread aggressively, causing rare necrotizing fasciitis with breast involvement. Early recognition, imaging, and multidisciplinary treatment are crucial for survival.
Area of Science:
- Infectious Diseases
- Oral Surgery
- Critical Care Medicine
Background:
- Odontogenic infections frequently cause deep neck space infections.
- Rapid fascial plane spread can lead to severe complications like necrotizing fasciitis, mediastinitis, and sepsis.
- This case details an unusual odontogenic infection with necrotizing fasciitis and bilateral breast involvement.
Purpose of the Study:
- To report an exceptionally rare case of odontogenic deep neck infection.
- To highlight the aggressive potential and life-threatening spread of such infections.
- To emphasize the importance of early diagnosis and comprehensive management.
Main Methods:
- A case report of a 58-year-old female patient with comorbidities (diabetes, hypertension, coronary artery disease).
- Presentation included neck and chest wall swelling, erythema, crepitus, and sepsis following inadequate treatment of a buccal abscess.
- Diagnostic imaging (contrast-enhanced CT) revealed extensive spread, including bilateral breast involvement. Treatment involved resuscitation, broad-spectrum antibiotics, serial surgical debridements, and negative pressure wound therapy (NPWT).
Main Results:
- Imaging confirmed multicompartment spread with subcutaneous emphysema, myositis, abscess formation, and bilateral breast involvement.
- The patient underwent aggressive resuscitation, broad-spectrum intravenous antibiotics, and multiple surgical debridements.
- Negative pressure wound therapy (NPWT) was utilized, leading to clinical and laboratory improvement.
Conclusions:
- Odontogenic infections can extend to the thoracic wall and breast tissue, necessitating early imaging and source control.
- Diabetes mellitus was a significant predisposing factor for the observed rapid and extensive spread.
- Prompt diagnosis, contrast-enhanced CT, multidisciplinary care, and surgical intervention are vital for reducing morbidity and mortality.
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