Two Nonagenarian Cases of Necrotizing Fasciitis Caused by Dental Infection

Abstract

Necrotizing fasciitis is a high-fatality infectious disease that can rapidly progress to severe conditions such as septic shock, disseminated intravascular coagulation, and multiple organ failure. This study reports two nonagenarian cases of necrotizing fasciitis resulting from dental infections. Both patients required immediate intensive care unit (ICU) admission following debridement and drainage performed in the operating room. Furthermore, both patients were in shock, necessitating noradrenaline administration for 2 and 3 days, respectively. The first case involved a 92-year-old male patient on maintenance dialysis, who presented with swelling in the right mandible. Computed tomography scan revealed necrotizing fasciitis secondary to mandibular osteomyelitis. He was extubated on postoperative day 4 and transferred to the ICU on postoperative day 9. The second case was a 93-year-old woman on home oxygen therapy, who presented with buccal swelling and pain. She underwent wound debridement under sedation and remained in postoperative care for 7 days. The patient was extubated on the day 8 and moved to the ICU on the day 10. These cases demonstrate that early debridement and intensive care management can effectively treat necrotizing fasciitis, even in nonagenarian patients.