Servical necrotizing soft tissue infection due to tooth abscess in a pregnant patient: A rare case

Abstract

Necrotizing soft tissue infections (NSTI) are life threatening infections with high rates of mortality and morbidity. In the present article we discuss cervical NSTI following a tooth abscess in a 19-year-old female patient with 24 week pregnancy in comparison with the literature on the subject. The patient with cervical abscess in the right submandibulary area following a tooth abscess underwent abscess drainage by the ear-nose-and throat surgery clinic. Because there was a bad smelling drainage from the incision from where a drainage was performed in the postoperative third hour, an occurrence of crepitation around 5 cm's of the surgical area, and the deterioration of the patient's general condition she was consulted by us and went into emergency surgery with a NSTI prediagnosis. NSTI was seen intraoperatively in the cervical area and a radical debridement was performed. The patient's tissue vitality was enabled through recurrent debridements in the postoperative period.

The occurrence of NSTIs is quite rare in the cervical area. The most important reason for this is based on the fact that the area has a rich blood flow. The reason for the development of NSTIs of the cervical area is mostly dental pathologies and these are followed by parafarengeal and peritonsillar infections. We also think that the patient's pregnancy had a progressive effect on the infection. If the patient survives with radical debridement, intensive care support, and appropriate antibiotherapy, the reconstruction of the past wide defect proves to be a challenging process. Thus, NSTI treatment requires a multidisciplinary approach.