Cases reported "Focal Infection, Dental"

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1/125. Toxic shock syndrome secondary to a dental abscess.

    A 9-year-old girl presented with arthralgia and myalgia which progressed to developing renal failure and overwhelming septic shock. The underlying cause was assumed to be a periodontal abscess from an upper right deciduous canine tooth. The pus from the abscess grew a toxic shock syndrome toxin 1-producing staphylococcus aureus. This case illustrates the importance of an oral surgical review of patients presenting with features of toxic shock syndrome if the source of the infection is not immediately obvious.
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keywords = infection
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2/125. Descending necrotizing mediastinitis caused by odontogenic infections.

    Intrathoracic dissemination of an odontogenic infection is very infrequent. The resulting clinical manifestation, known as descending necrotizing mediastinitis, causes high mortality. Due to the absence of early clinical or radiological signs, diagnosis is usually made only when the process is completely established. Treatment is a combination of intravenous antibiotics and mediastinal drainage, via either a cervical or a transthoracic approach. We report the clinical and microbiological characteristics of 4 patients with descending necrotizing mediastinitis, and their clinical course over a period of 10 years.
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keywords = infection
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3/125. Management of mandibular fascial space infection of odontogenic origin.

    Cellulitis is an acute, painful infection whose swelling is larger with diffuse borders. When palpated, early cellulitis can be very soft or doughfy; a severe cellulitis is almost always described as indurated or even as being "board-like". It can be innocuous in its early stages and extremely dangerous in its more advance, indurated, rapidly spreading stages. Randy, a 16 years old boy who thought that a regularly occurring toothache can advance into a life-threatening complication has a lot to be thankful for. The patient was referred to the pediatric dentistry Division by the E.R. doctors for further evaluation and management due to a swelling on the lower quadrant of his face. This was on the 8th day after he experienced the first pain on tooth no. 47.
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4/125. Chronic factitial ulcer of chin cured by endodontic (root-canal) surgery for underlying periapical abscess.

    In a determined search for the cause of a "factitial" ulcer of the jaw, consultation with 3 dentists was required before an underlying periapical abscess was discovered. Within 3 months of endodontic surgery, this ulcer of 12 years duration had completely healed and remains healed. Too often dental infection is neither suspected nor detected as a cause of skin disease.
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keywords = infection
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5/125. Postanginal septicaemia with external jugular venous thrombosis: case report.

    Postanginal septicaemia is a syndrome of anaerobic septicaemia, septic thrombophlebitis of the internal jugular vein, and metastatic infections, that follows a localized infection in the area drained by the large cervical veins. The syndrome was well-known and often fatal in the preantibiotic era. It is now rather rare, presumably as a result of the almost routine use of prophylactic antibiotics. The symptoms are classic, and it should be suspected in any case where septicaemia and metastatic lesions are preceded by a head and neck infection. We report a case that is typical, except that branches of the external jugular vein were thrombosed. To our knowledge this has not been reported previously.
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ranking = 3
keywords = infection
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6/125. orbital cellulitis as a sole symptom of odontogenic infection.

    A case of periapical infection resulting in unilateral maxillary sinusitis and cellulitis of the ipsilateral lower eyelid is presented. The sole symptom was right orbital swelling. The possible pathway for the spread of this type of infection predisposing factors and possible complications are reviewed. The value of radiographic examination and antibiotic therapy are also discussed.
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ranking = 6
keywords = infection
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7/125. Descending necrotizing mediastinitis: report of a case.

    A 47-year-old man was admitted to our hospital for treatment of an odontogenic infection. He presented with a fever, signs of sepsis, and neck swelling, and was initially diagnosed as having a neck abscess. After cervical drainage, he showed no improvement, and mediastinitis was detected by chest X-ray and computed tomography. A thoracotomy and mediastinal drainage was subsequently performed for descending necrotizing mediastinitis, which resulted in marked improvement. To date, only 83 cases of descending necrotizing mediastinitis have been reported in japan. We present herein an additional case, followed by a review of the Japanese literature.
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keywords = infection
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8/125. pseudomonas aeruginosa septicaemia from an oral source.

    Oral colonisation with aerobic Gram-negative bacilli (AGNB) is abnormal and usually indicates a medically compromised state in the host. It has been postulated that oral colonisation with AGNB may predispose a patient to serious systemic infection, but proof of this assertion is lacking. This report describes an elderly patient who had oral colonisation of pseudomonas aeruginosa and developed septicaemia from an identical strain of this bacterium.
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9/125. Bacterial endocarditis of dental origin: report of case.

    Although appreciated by most practitioners, the fact that dental infection may be the source of bacteremia without a history of recent dental procedures is occasionally overlooked. The case reported here illustrates what we feel is an example of such a phenomenon. The eradication of the oral foci of infection enhanced the patient's response to therapy and prompted his ultimate recovery.
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ranking = 2
keywords = infection
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10/125. Descending necrotizing mediastinitis due to odontogenic infections.

    OBJECTIVE: Acute purulent mediastinitis caused by oropharyngeal infection is termed descending necrotizing mediastinitis. Such infections usually have a fulminate course, leading to sepsis and frequently to death. The purpose of this study is to show the importance of early diagnosis, aggressive surgical intervention, and optimal antibiotics chemotherapy in controlling this fatal infectious disease. STUDY DESIGN: Two patients with descending necrotizing mediastinitis due to odontogenic infection who were treated at our institution are described. RESULTS: Both patients survived. CONCLUSIONS: From the patients, 23 different aerobic and anaerobic bacteria were isolated. All of the isolates were susceptible to carbapenem. Early evaluation by means of cervicothoracic computed tomography scanning was extremely useful for diagnosis and surgical planning. knowledge of anatomic pathways from the mouth to the mediastinum is essential. We believe that tracheostomy is not always necessary. In both of the cases presented, mediastinal drainage was completed through use of a transcervical approach. However, a more aggressive drainage including tracheostomy might be necessary when the infection extends below the carina.
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