Abstract
Two cases of necrotizing fasciitis in the cheek and temporal region caused by dental infection and treated with limited doses of antimicrobial agents are reported. Patient 1, a 70-year-old woman with hepatic cirrhosis and diabetes mellitus, had swelling of the right cheek and temporal regions due to pericoronitis of a lower wisdom tooth. Patient 2, a 71-year-old woman with renal insufficiency, had swelling of the left side of the neck, submandibular region, cheek, and temporal region due to pericoronitis of a lower wisdom tooth.
Computed tomography demonstrated a gas-forming abscess in the subcutaneous tissue and musclein both patients. The patients were given a diagnosis of necrotizing fasciitis, and surgical drainage was performed. Necrosis of the superficial fascia and subcutaneous tissues wasfound and involved the deep fascia. and muscles. Chemotherapy with a limited dose was started. Daily debridement and irrigation with hydrogen peroxide solution, povidone isodine solution, or benzalkonium chrolide solution, resulted in improvement of symptoms. The importance of early diagnosis followed by appropriate treatment including prompt drainage, localirrigation, administration of antibiotics, and management of general condition is emphasized.
