Prevotella denticola septic embolic cerebral infarction after difficult lower wisdom tooth extraction

Necrotizing Fasciitis Due to Prevotella denticola Infection in an Intravenous Drug User

Intravenous drug users (IVDUs) have an increased risk for various types of local and systemic infections including necrotizing fasciitis (NF), which is a life-threatening bacterial soft tissue infection that requires a prompt diagnosis and treatment. Prevotella denticola is a part of the Prevotella species, which are obligate anaerobic, Gram-negative rods related to Bacteroides genus and often implicated in periodontal and dental disease, but have been associated with soft tissue infections and other systemic complications such as cerebral abscess and endocarditis. This case reports a 30-year-old female IVDU who presented with necrotizing fasciitis of the right anterior thigh with associated right knee septic arthritis due to Prevotella denticola. The patient was treated with emergent irrigation and radical debridement along with IV antibiotic treatment for eight weeks. A review of literature was performed regarding necrotizing fasciitis caused by Prevotella species. Necrotizing fasciitis caused by Prevotella species is rare; however, there must be a high index of suspicion among IVDUs to allow for a prompt diagnosis and treatment.