[Necrotizing cervico-facial cellulitis of dental origin in a developing country]

Rev Mal Respir. 2017 Sep;34(7):742-748. doi: 10.1016/j.rmr.2016.03.006. Epub 2016 May 4.
[Article in French]

Abstract

Introduction: Necrotizing cellulitis of dental origin is a serious disease and requires prompt and effective management to avoid adverse outcomes. The purpose of this work is to describe the diagnostic and therapeutic difficulties encountered in this condition.

Methods: This was a prospective study in the thoracic surgery department of Mali Hospital from January 2011 to February 2015. We collected consecutively 19 cases of complicating cervico-facial cellulitis of dental origin. The anatomical and clinical aspects, therapeutic modalities and difficulties are described.

Results: Dental pain and fever were the predominant symptoms followed by cervical edema. Chest CT-scan was the basis for the diagnosis in all cases. Cervicotomy with debridement was the most performed surgical procedure. Pleural drainage was performed in 6 cases. Three patients (15.8%) died.

Conclusion: Necrotizing cellulitis of dental origin is a serious disease with high morbidity and mortality. The key radiological examination is the thoracic CT-scan. Early medico-surgical management by emergency care, tailored antibiotic therapy, removal of necrotizing tissues and drainage of collections are required to deliver a good outcome.

Keywords: Antibiothérapie; Antibiotic therapy; Cellulite; Cellulitis; Cervicotomie; Cervicotomy; Dental care; Dentisterie.

MeSH terms

  • Adult
  • Cellulitis / diagnosis
  • Cellulitis / epidemiology
  • Cellulitis / etiology*
  • Cellulitis / pathology
  • Developing Countries / statistics & numerical data
  • Drainage
  • Face / pathology*
  • Female
  • Humans
  • Male
  • Mali / epidemiology
  • Middle Aged
  • Neck / pathology*
  • Necrosis / complications
  • Necrosis / diagnosis
  • Necrosis / epidemiology
  • Necrosis / therapy
  • Retrospective Studies
  • Skin Transplantation
  • Stomatognathic Diseases / complications*
  • Stomatognathic Diseases / diagnosis
  • Stomatognathic Diseases / epidemiology
  • Stomatognathic Diseases / therapy
  • Young Adult