{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:20:02Z","timestamp":1788441602286,"version":"build-2803163510"},"reference-count":14,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,6,18]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>\n                    Odontogenic infections are commonly considered a cause of Ludwig\u2019s angina; their progression to necrotising fasciitis (NF) is rare and often associated with significant morbidity and mortality. We report a case of a previously healthy patient in his 20s, a heavy smoker, who developed extensive cervicothoracic NF after wisdom tooth extraction. He initially presented with neck swelling and pain, with stable vital signs and no airway compromise. Within 24 hours, he deteriorated abruptly with respiratory distress and septic shock. CT showed widespread fascial involvement with emphysema tracking into the mediastinum and bilateral pleural effusion. His Laboratory Risk Indicator for Necrotising Fasciitis score was 7, indicating high risk. He required emergent, extensive, repeated debridement, chest drainage and later thoracoscopy. Cultures predominantly grew\n                    <jats:italic>Streptococcus anginosus<\/jats:italic>\n                    . Despite multiple complications, he fully recovered. This case shows that NF can occur even in young, healthy patients, underscoring the importance of early recognition and aggressive management.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2026-272322","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:30:40Z","timestamp":1782912640000},"page":"e272322","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Necrotising fasciitis of the neck, chest and abdomen arising from odontogenic Ludwig\u2019s angina in a healthy young adult"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6438-9022","authenticated-orcid":false,"given":"Hend S","family":"Esmaeili","sequence":"first","affiliation":[{"name":"Anesthesia, Al Sabah Hospital, Shuwaikh, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3352-0717","authenticated-orcid":false,"given":"Meshal J","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Environment and Life sciences, KISR, Safat, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"2026090306052074000_19.7.e272322.1","article-title":"An Unusual Presentation of Ludwig\u2019s Angina Complicated by Cervical Necrotizing Fasciitis: A Case Report and Review of the Literature","volume":"2012","author":"Chueng","year":"2012","journal-title":"Case Rep Otolaryngol"},{"key":"2026090306052074000_19.7.e272322.2","doi-asserted-by":"publisher","DOI":"10.1093\/bjaceaccp\/mks033"},{"key":"2026090306052074000_19.7.e272322.3","doi-asserted-by":"crossref","first-page":"NP109","DOI":"10.1177\/0145561321991341","article-title":"Cervical Necrotizing Fasciitis, Diagnosis and Treatment of a Rare Life-Threatening Infection","volume":"102","author":"Hua","year":"2023","journal-title":"Ear Nose Throat J"},{"key":"2026090306052074000_19.7.e272322.4","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.idcr.2016.03.001","article-title":"Ludwig\u2019s angina complicated by fatal cervicofascial and mediastinal necrotizing fasciitis","volume":"4","author":"Manasia","year":"2016","journal-title":"IDCases"},{"key":"2026090306052074000_19.7.e272322.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12901-018-0059-y","article-title":"Odontogenic necrotizing fasciitis: a systematic review of the literature","volume":"18","author":"Gore","year":"2018","journal-title":"BMC Ear Nose Throat Disord"},{"key":"2026090306052074000_19.7.e272322.6","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9371"},{"key":"2026090306052074000_19.7.e272322.7","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1177\/22925503211034830","article-title":"Predictors of Mortality in Patients With Necrotizing Fasciitis: A Literature Review and Multivariate Analysis","volume":"31","author":"Kjaldgaard","year":"2023","journal-title":"Plast Surg (Oakv)"},{"key":"2026090306052074000_19.7.e272322.8","unstructured":"Wallace HA , Perera TB . Necrotizing fasciitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2026. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK430756\/"},{"key":"2026090306052074000_19.7.e272322.9","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002774"},{"key":"2026090306052074000_19.7.e272322.10","doi-asserted-by":"crossref","DOI":"10.1111\/iwj.14379","article-title":"Early diagnosis of necrotizing fasciitis: Imaging techniques and their combined application","volume":"21","author":"Wei","year":"2024","journal-title":"Int Wound J"},{"key":"2026090306052074000_19.7.e272322.11","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/QCO.0000000000000988","article-title":"Necrotizing fasciitis: an update on epidemiology, diagnostic methods, and treatment","volume":"37","author":"Allaw","year":"2024","journal-title":"Curr Opin Infect Dis"},{"key":"2026090306052074000_19.7.e272322.12","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/01.NURSE.0000694752.85118.62","article-title":"Necrotizing fasciitis: A comprehensive review","volume":"50","author":"Chen","year":"2020","journal-title":"Nursing"},{"key":"2026090306052074000_19.7.e272322.13","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31823fac60"},{"key":"2026090306052074000_19.7.e272322.14","first-page":"1029","article-title":"A Fatal Outcome of Ludwig\u2019s Angina and Necrotizing Fasciitis Following Traditional Tooth Extraction","volume":"17","author":"Abukar","year":"2024","journal-title":"Int Med Case Rep J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-272322","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:05:29Z","timestamp":1788440729000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-272322"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":14,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,1]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bcr-2026-272322"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-272322","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}