Necrotizing fasciitis of odontogenic origin in a nonimmunoco
The present case has been published in the Journal of Scientific Society.

A 53-year-old male patient reported with the complaint of swelling and discharge in the left lower one-third of the face and the upper part of neck for the past 2 days.

He had been seen previously by a dentist who drained abscess giving extraoral incision that yielded pus and the patient was put on a course of routine antibiotics and analgesics. However, the patient was not relieved of symptoms. A day later patient developed swelling in the upper part of the neck associated with severe pain, fever, and dysphagia. It was at this stage that patient reported to the outpatient dental department.

Examination of the site revealed a diffuse swelling on the left lower third of the face extending from ala-tragal line to 4 cm below the lower border of the mandible toward the upper part of the neck. Skin over the swelling was slightly stretched, shiny generalized erythematous appearance with foul smelling purulent discharge from the incised area.

Few blackish dusky spots were present. On palpation, the swelling was tender with the rise of local temperature. Submandibular and upper group of cervical lymph nodes were palpable and tender. There was no involvement of the parotid gland as there was no rise of ear lobule.

The patient was admitted for surgical debridement. Empirically, the patient was put on amoxicillin + clavulinic acid 1.2 g intravenously every 8 th hourly, amikacin 500 mg intravenously every 12 th hourly, metranidazole 500 mg infusion every 8 th hourly along with diclofenac sodium 75 mg intramuscularly every 8 th hourly. Then the patient was shifted to the operating room. Under general anesthesia, he underwent aggressive incision (submandibular) and drainage.

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