41/162. Endogenous group G streptococcus endophthalmitis following a dental procedure. PURPOSE: To report a case of bilateral endogenous endophthalmitis due to group G streptococcus after a dental procedure. methods: Case report of a 69-year-old woman who presented with pain, decreased vision, bilateral uveitis, and a unilateral hypopyon 1 week after treatment for an abscessed tooth. RESULTS: Bilateral endophthalmitis was diagnosed, and group G streptococcus was cultured from the vitreous samples. CONCLUSIONS: To our knowledge, this is the second reported case of endogenous endophthalmitis following a dental procedure. Furthermore, it was due to group G streptococcus, which is a rare cause of this condition. ( info) |
| In this paper, we report one case of severe brain abscess in which Porphyromonas gingivalis was detected in the spinal fluid. ( info) |
| A case of descending mediastinitis resulting from dental infection and complicated by adult respiratory distress syndrome (ARDS) is reported. The patient had a long history of heavy drinking. His condition was so serious that he died despite some successful therapies. The cause of ARDS appeared to be aspiration pneumonia. It is extremely rare for oral and maxillofacial surgeons to encounter a patient with ARDS. ( info) |
44/162. Odontogenic infections and descending necrotising mediastinitis: case report and review of the literature. Descending necrotising mediastinitis is a rare complication secondary to oral surgery or odontogenic infections which ultimately spreads to the mediastinum through the anatomical cervical spaces. Delay in diagnosis, despite broad-spectrum antimicrobical therapy and extensive surgical intervention, results in an unacceptably high mortality rate (almost to 40%). A case study is presented as a rationale for a review of the current literature and to analyse the evolution in therapies, both medical and surgical from Pearse in 1938 to today. ( info) |
45/162. Paediatric necrotizing fasciitis complicating third molar extraction: report of a case. Necrotizing fasciitis is an uncommon but well-described entity. In the paediatric population compromising risk factors are frequently absent. We describe the successful treatment of a case of cervicofacial necrotizing fasciitis in a healthy 14-year-old male following routine extraction of an uninfected wisdom tooth for orthodontic purposes. ( info) |
46/162. Acute tongue abscess. Report of three cases. Abscess of the tongue seems to be a rare clinical entity and is a potentially life-threatening infection. It may result in airway compromise and disseminated infection to other regions. Thus, a tongue abscess should be considered in all cases of acute tongue swelling, especially when host defences are severely impaired. In acute cases the diagnosis of tongue abscess can be reached clinically. Needle aspiration of pus collection is a useful diagnostic and therapeutic tool, which provides considerable amelioration of symptoms. Three cases of tongue abscess are reported, along with discussion of the presentation, pathophysiology, differential diagnosis, and management of this disease. ( info) |
47/162. Management of extra oral sinus cases: a clinical dilemma. The cutaneous sinus tract of dental origin is an uncommon but well documented condition. Its diagnosis is not always easy unless the treating clinician considers the possibility of its dental origin. Such patients may undergo multiple surgical excisions, biopsies, and antibiotic regimens, but all of them fail with the recurrence of the sinus tract. This is because the primary etiology is incorrectly diagnosed. This case report describes the treatment of four patients presenting with variable complaints of pain and purulent or hemorrhagic discharge from lesions of the face. Clinical and radiographic examination revealed carious teeth with radiolucent areas indicating chronic periradicular abscess. The teeth were restorable, so nonsurgical endodontic therapy was performed in all of them. No systemic antibiotic therapy was provided. The patients responded well, and the cutaneous lesions healed uneventfully. Improper diagnosis can lead to needless loss of teeth that can be otherwise maintained through timely and proper management. ( info) |
48/162. mediastinitis caused by an infected mandibular cyst. Descending necrotizing mediastinitis is a potentially fatal condition which may occur seldom as a consequence of oral infections. This report describes the management of a patient with mediastinitis due to an infected dentigerous cyst. ( info) |
49/162. How serious are oral infections? life-threatening conditions following dental infections have been rare since antibiotics were introduced into the world of medicine. However, infections spreading through the soft tissues of the head and neck are encountered occasionally and mortality is still reported as a result of sepsis or airway embarrassment. A case of ludwig's angina from odontogenic infection that progressed into mediastinitis and pericarditis is presented. The steps adopted in the management of this case highlight the significance of early recognition and diagnosis of the source of deep cervical infections, the importance of securing the airway, effecting surgical drainage and aggressive intravenous antibiotic therapy. ( info) |
50/162. Fatal necrotizing fasciitis of dental origin. Necrotizing fasciitis is a potentially fatal, acute bacterial infection characterized by extensive fascial and subcutaneous tissue necrosis. Four factors that contribute significantly to the morbidity and mortality of necrotizing fasciitis are: 1) delayed treatment, due to difficulty in recognizing the condition; 2) inappropriate treatment; 3) host debilitation; and 4) a polymicrobial infection. ( info) |