Abstract
Necrotizing fasciitis is a serious infection characterized by rapid necrosis of the fascia and subcutaneous tissue. We report a case of deep cervical abscess, which was considered to be necrotizing fasciitis caused by apical periodontitis of the right maxillary third molar. The patient was a 59-year-old Japanese man who visited our hospital complaining of swelling and pain in his right lower jaw. Diffuse swelling with redness was observed from the right lower jaw to the neck. He was diagnosed with cervical cellulitis due to apical periodontitis in the right maxillary third molar. The patient immediately was treated with an antimicrobial as well as incision and drainage. At that time, extensive necrotic tissue was observed along the fascia, and bacterial tests revealed Peptostreptococcus micros. Since cervical necrotizing fasciitis was suspected, necrotic tissues were removed and washed as appropriate. Then, dermatoplasty on the cervical skin defect and extraction of the causative teeth were performed. For successful treatment of cervical necrotizing fasciitis, early diagnosis and aggressive surgical procedures are important, because deep cervical abscesses often become fatal if they become serious.
