Hyperbaric oxygen therapy as adjuvant therapy in necrotizing fasciitis of the face: case report

Abstract

Facial necrotizing fasciitis is a rare bacterial infectious disease. Rapid necrosis of the tissues and suppurative fasciitis is pathognomonic. It can be seen following odontogenic infection. Early aggressive debridements and wide-spectrum antibiotic therapy are currently accepted treatments. A 60-year-old man was admitted to the otolaryngology clinic for facial pain and swelling after odontogenic infection. Inflamed left maxilla and orbit were seen, and abscess contents spontaneously drained into the mouth. It was determined that infectious markers were increased in the blood. On MRI, a broad abscess with edema and gas formation was seen. Debridement of the necrotic tissue was performed immediately and wide-spectrum antibiotic therapy was started. Infection was stopped and wound was closed, with four weeks of antibiotic therapy, three sessions of debridement, and 30 sessions of hyperbaric oxygen (HBO2) therapy. HBO2 therapy must not replace the combination of early aggressive debridements and wide-spectrum antibiotic therapy, but rather must be considered as an important adjuvant treatment.