Necrotizing cervical fasciitis of unknown origin.

Necrotizing fasciitis is an acute soft-tissue infection rarely seen in the head and neck area. The case of a 29-year-old female with necrotizing cervical fasciitis of unknown origin is presented. These infections usually result from dental infections; this patient, however, denied any associated dental problems. The patient presented with an erythematous swelling over the anterior neck associated with a choking sensation and an elevated WBC suggestive of acute thyroiditis. After three days of hospitalization the skin over the anterior neck area became necrotic. Surgical debridement of the area was undertaken with significant improvement. Once wound healing had commenced a pedicled flap was used to reconstruct the large defect. Flap selection for closure of the defect is discussed. It is apparent that early recognition and surgical debridement of necrotizing fasciitis is vital to ensure a rapid recovery.