Necrotizing fasciitis (NF) is a critical, life-endangering infection of the soft tissues that targets the deep fascia and subcutaneous layers. Its hallmark is fulminant progression and a high fatality rate. NF in the head and neck region is extremely rare, and dental sources account for the majority of cases. This paper aims to provide an exhaustive review of the principal characteristics of cervical necrotizing fasciitis (CNF) in adults, supplementing the literature with our own clinical insights into its treatment. The most frequently harvested pathogens are Streptococcus spp. and Staphylococcus spp. Patient outcomes become exceedingly bleak if the infection descends and establishes mediastinitis. Given that early signs can mimic a standard, non-necrotizing deep cervical infection, maintaining keen clinical alertness is vital for prompt detection. Computed tomography imaging is indispensable for confirming the diagnosis, mapping the spread of the disease/eliminating the possibility of descending mediastinitis. Immediate and extensive surgical removal of all nonviable tissue, alongside intravenous antibiotics and aggressive fluid replacement, are non-negotiable pillars of care that must commence without delay for culture reports. Even with swift and optimal treatment, the associated mortality of CNF is known to reach rates as steep as 35%.
