Recurrent subgaleal abscess following cervicofacial necrotizing fasciitis: A case report

Background: Subgaleal abscess (SGA) is an uncommon but potentially life-threatening condition characterized by pus accumulation between the galea aponeurotica and skull periosteum. Necrotizing fasciitis (NF) of the head and neck is an aggressive infection with high morbidity and mortality. While SGAs have been reported following trauma, neurosurgical interventions, or regional infections, recurrent SGA secondary to cervicofacial NF (CNF) has not previously been documented. Case Description: We present the case of a 75-year-old woman with diabetes mellitus and multiple comorbidities who developed CNF complicated by recurrent SGA. Despite initial drainage procedures, the patient experienced repeated relapses due to capsule formation. Definitive resolution was achieved only after complete capsule excision, in addition to culture-directed antibiotic therapy. Conclusion: Recurrent SGA complicating CNF is exceedingly rare. This case underscores the importance of early recognition, thorough surgical intervention including capsule excision, and vigilant follow-up to achieve durable infection control in patients with significant comorbidities.