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Case Report
Profound necrotizing fasciitis of the neck and chest wall secondary to simple tooth extraction necessitating surgical tracheostomy and reconstruction
1 Consultant Oral and Maxillofacial Surgery/Head and Neck Surgeon, Royal Cornwall Hospital, Cornwall, UK
2 DCT 1 Oral and Maxillofacial Surgery, James Cook Hospital, Middlesbrough, UK
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Karim Kassam
Consultant Oral and Maxillofacial Surgery/Head and Neck Surgeon, James Cook Hospital, Middlesbrough,
UK
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Article ID: 101530Z01KK2026
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Kassam K, Galia R. Profound necrotizing fasciitis of the neck and chest wall secondary to simple tooth extraction necessitating surgical tracheostomy and reconstruction. Int J Case Rep Images 2026;17(1):12–17.ABSTRACT
Introduction: Cervical necrotizing fasciitis (CNF) is a rare, but serious condition that can develop as a result of an odontogenic infection spreading into the deep fascial planes of the neck. The infection is associated with significant morbidity and mortality due to septic shock and consequent multiple organ failure. Early diagnosis is of paramount importance with immediate surgical management and appropriate antimicrobial therapy being key in obtaining a good outcome. Patients require aggressive surgical resection necrotic tissues which can affect form and function in the head and neck. Surgeons dealing with cervical necrotizing fasciitis should be skilled in tracheostomy, have good knowledge of head and neck anatomy, able to deal with fasciitis around neck vessels, and the ability to reconstruction the neck as needed.
Case Report: A case of CNF affecting a 31-year-old male, who was treated with multiple rapid surgical debridements, intravenous antibiotics, and tracheostomy, is presented. Transfer to a neighboring unit was needed due to concern of potential spread to the mediastinum necessitating cardio-thoracic intervention. After further debridements, artificial skin grafting and reconstruction were carried, and the patient was successfully discharged from the hospital.
Conclusion: Cervical necrotizing fasciitis is a relatively uncommon, rapidly progressive, and often life-threatening soft tissue infection. Early diagnosis, aggressive antibiotic, and surgical treatment play a vital role in the management of the disease. In patients with resultant skin or soft tissue defects, advanced reconstructive techniques are needed to close resultant defects.
Keywords: Cervical, Fasciitis, Infection, Necrotizing, Odontogenic
SUPPORTING INFORMATION
Acknowledgments
Mr. Alexander Armstrong, Consultant Plastic Surgeon, University Hospitals Plymouth.
Author ContributionsKarim Kassam - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Roshni Galia - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 Karim Kassam et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
