[Necrotizing cervico-facial cellulitis of dental origin in a developing country]. / Les cellulites cervico-faciales nécrosantes d'origine dentaire dans un pays en voie de développement.

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.