Necrotizing fasciitis (NF) is a rare life threatening infection progressing along the superficial and deep fascias of the skin. Involvement of the face is very rare. A 58-years old diabetic woman was admitted in our department, complaining about pain in the left malar region since 3 days and progressive left side vision loss. Clinical examination was performed and the diagnosis of NF of dental origin was made. The patient was immediately referred for surgery and unfortunately a total exenteration of the orbit had to be performed in order to prevent the infection from spreading in the cavernous sinus. This was followed by subcutaneous debridement and a homolateral maxillary teeth removal with bone curettage.

A review of the literature is made and the etiology, the pathogenesis, the diagnosis and the treatment of this pathology are discussed. Through this clinical case, we report our treatment strategy to save in one hand the life of the patient, and in the other hand the non-necrotic skin in order to prevent severe functional and esthetic repercussion.

Conflict of interest: None declared.