Authors
Awe O. O., Aigbonoga Q. O., Amuwah G., Blackie F. F., Azeke K. E., Ijiogbe O. E., Agbogidi I.
Abstract
Necrotizing fasciitis is a common debilitating disease usually presenting in a patient that is immunocompromised
patients due to malnutrition, immunosuppression, elderly, diabetes mellitus, etc. It is a fulminant rapidly progressive
infection secondary mainly to mixed organisms (both aerobic and anaerobic organisms). Necrotizing fasciitis of the
neck usually follows Ludwig’s angina this arises from neglected dental caries or ruptured caseous cervical
lymphadenopathy in patients with pulmonary tuberculosis.We present an 81-year-old woman, who presented with a
fungating ulcer on the left side of the neck and significant, effortless, bleeding from the upper gastrointestinal system
of 2 episodes. There was an antecedent history of dental pain and swelling which was treated with antibiotics and
analgesia purchased over-the-counter. The swelling subsequently ruptures leading to the fungating ulcer. There was
an associated history of passage of melaena and hematochezia. There was an initial misdiagnosis of massive upper
gastrointestinal bleeding in this index patient with necrotizing fasciitis following ruptured Ludwig’s angina. She was
later investigated (indirect laryngoscopy) and bleeding was identified in the hypopharynx on the left side.
patients due to malnutrition, immunosuppression, elderly, diabetes mellitus, etc. It is a fulminant rapidly progressive
infection secondary mainly to mixed organisms (both aerobic and anaerobic organisms). Necrotizing fasciitis of the
neck usually follows Ludwig’s angina this arises from neglected dental caries or ruptured caseous cervical
lymphadenopathy in patients with pulmonary tuberculosis.We present an 81-year-old woman, who presented with a
fungating ulcer on the left side of the neck and significant, effortless, bleeding from the upper gastrointestinal system
of 2 episodes. There was an antecedent history of dental pain and swelling which was treated with antibiotics and
analgesia purchased over-the-counter. The swelling subsequently ruptures leading to the fungating ulcer. There was
an associated history of passage of melaena and hematochezia. There was an initial misdiagnosis of massive upper
gastrointestinal bleeding in this index patient with necrotizing fasciitis following ruptured Ludwig’s angina. She was
later investigated (indirect laryngoscopy) and bleeding was identified in the hypopharynx on the left side.
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