1/5. 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.- - - - - - - - - - ranking = 1keywords = toxic shock syndrome, toxic shock, shock syndrome, septic shock (Clic here for more details about this article) |
2/5. Cervical necrotizing fasciitis of odontogenic origin: a report of 11 cases.PURPOSE: Although most cases of cervical necrotizing fasciitis (CNF) are odontogenic in origin, reports of this disease in the dental literature are sparse. The purpose of this study was to review the cases treated on our service, and to analyze the features of this disease and the responses to management, to supplement the understanding of this relatively rare and life-threatening disease. patients AND methods: All cases of infection admitted to the OMS service in a period of 10.5 years were studied retrospectively. The diagnosis of CNF was established by the findings on surgical exploration and histologic examination. The patients' age, sex, medical status, causes of the infection, bacteriology, computed tomography scan findings, surgical interventions, complications, survival, and other clinical parameters were reviewed. RESULTS: A total of 422 cases of infection were admitted, and 11 cases of cervical necrotizing fasciitis were found. The incidence of CNF was 2.6% among the infections hospitalized on the OMS service. There were 7 male and 4 female patients. Eight patients were older than 60 years of age. Seven patients had immunocompromising conditions, including diabetes mellitus in 4, concurrent administration of steroid in 2, uremia in 1, and a thymus carcinoma in 1. All patients showed parapharyngeal space involvement; four also showed retropharyngeal space involvement. Gas was found in the computed tomography scan in 6 patients, extending to cranial base in 3 of them. Anaerobes were isolated in 73% of the infections, whereas streptococcus species were uniformly present. All patients received 1 or more debridements. Major complications occurred in 4 patients, including mediastinitis in 4, septic shock in 2, lung empyema in 1, pleural effusion in 2, and pericardial effusion in 1. All major complications developed in the immunocompromised patients, leading to 2 deaths. CONCLUSION: The mortality rate in this study was 18%. Early surgical debridement, intensive medical care, and a multidisciplinary approach are advocated in the management of CNF.- - - - - - - - - - ranking = 0.010681876000491keywords = septic shock (Clic here for more details about this article) |
3/5. mediastinitis from odontogenic infection. Report of three cases and review of the literature.Descending necrotizing mediastinitis secondary to dental infection occurs infrequently. The diagnosis of this condition is difficult and often a surgical approach is delayed due to initial clinical improvement after antimicrobial therapy. An incorrect evaluation of this apparent improvement may result in fatal mediastinitis and septic shock. We report 3 cases of mediastinitis of odontogenic origin. In one patient, a nonproductive cough was the first sign of thoracic involvement. A total of 25 similar cases of mediastinitis from odontogenic infection have been collected from the literature in the last 15 years. Some features have to be emphasized, such as the polymicrobial flora, the higher prevalence in males, and the high mortality rate of approximately 44%.- - - - - - - - - - ranking = 0.010681876000491keywords = septic shock (Clic here for more details about this article) |
4/5. Toxic shock syndrome: odontogenic origin.Although the majority of reported cases of toxic shock syndrome (TSS) in the united states continue to be associated with tampon use, TSS also occurs in postpartum women and in patients with pharyngitis, infected surgical wounds, cutaneous and subcutaneous infections, and infections of other body sites. The article presents the case of a 23-year-old black man in whom TSS developed secondary to an odontogenic infection.- - - - - - - - - - ranking = 0.64205430447998keywords = toxic shock syndrome, toxic shock, shock syndrome (Clic here for more details about this article) |
5/5. The presentation and complications of odontogenic septic shock. Report of a case.Although most odontogenic infections spread locally to adjacent fascial spaces, usually contiguous with the offending odontogenic pathosis, occasionally such an infection can spread rapidly across the midline and appear on the opposite side of the face and neck. Debilitated chronic alcohol abusers who are nutritionally deficient are more likely to develop serious life-threatening infections, either through serious airway involvement as seen in ludwig's angina or manifest as a gram-negative septicemia with life-threatening shock and even cardiac arrest, than the usual dental patient with cellulitis. Early recognition through a high index of suspicion and vigorous monitoring will pick up the initial manifestation of toxic shock, as noted in this case report.- - - - - - - - - - ranking = 0.13316567839461keywords = toxic shock, septic shock (Clic here for more details about this article) |