61/162. Childhood craniofacial Burkitt's lymphoma presenting as maxillary swelling: report of a case and review of literature. Burkitt's lymphoma (BL) is an undifferentiated malignant lymphoma comprising of uniformly primitive lymphoreticular cells. The tumor was seen originally in patients in africa. African type BL usually occurs in the jaws of young children. In American cases, abdominal involvement predominates. Strong evidence implicats Epstein-Barr virus in the development of BL. BL is found most commonly in childhood, with a peak incidence in African cases at 5 to 8 years old and in American cases at 10 to 12 years old. The disease shows a preference for males in a 2:1 to 4:1 ratio. BL is the most rapidly growing neoplasm requiring immediate diagnosis and treatment; however, it is extremely sensitive to chemotherapy. In this report, a case of BL that was initially misdiagnosed as an acute dental abscess is presented and the role of the dentist in the diagnosis and treatment of these patients is emphasized. ( info) |
| The aim of the present study was to estimate average age of the patients in both sexes treated for MS, distribution by sex, amount of dexter and sinister MS with and without the fistulas into the maxillary sinus, with and without the foreign-bodies, length of stay in the Department of Maxillofacial Surgery at Kaunas Hospital of University of medicine during the period from 1999 till 2004. The retrospective data analysis of the patients' treated from chronic MS was made. 346 patients (213 females and 133 males) were treated for chronic MS. 55 cases of chronic dexter MS with a fistula into maxillary sinus, 98 cases of chronic dexter MS without a fistula, 45 cases of chronic sinister MS with a fistula, 112 cases chronic sinister MS without a fistula, 16 cases of foreign-bodies in dexter maxillary sinus, 20 cases of foreign-bodies in sinister maxillary sinus have been detected. The main age of the female was 46.6 /-15.0, the main age of the men was 42.1 /-14.4. Statictically significant difference in the age difference of the women and the men was found (p=0.0024). It was determined, that females diagnosed and treated with chronic MS were 1.6 times more than males during the period from 1999 till 2004 in Kaunas Hospital of University of medicine. Females treated for chronic MS were 4.5 years older than males. ( info) |
| Organ abscesses are a rare and life-threatening complication mostly of hematogenously disseminated infections. We report a case of brain and liver abscesses. Identification of the lesions was made by contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI), respectively. An oral examination comprised an oral focus of infection. streptococcus intermedius was isolated from oral smear, liver and ventricular drainage, and blood sample. After the commencement of antibiotic therapy, drainage of abscesses and oral rehabilitation, complete recovery was noted. ( info) |
| Chronic osteomyelitis with subperiosteal new bone formation results from periosteal reaction to chronic inflammatory/infectious stimulation. In the maxillofacial region, it has traditionally been termed Garre's osteomyelitis with proliferative periostitis and more recently periostitis ossificans. The term Garre's osteomyelitis has been regarded as a misnomer by many authors in the recent literature. The term chronic osteomyelitis with proliferative periostitis, although cumbersome, is considered to be the most accurate description of the pathology. It usually affects the mandible of young patients secondary to dental infection. Management involves removal of the source of infection and antibiotic treatment. We present an unusual case of chronic osteomyelitis with proliferative periostitis affecting the mandible of a 12-year-old patient. The source of infection was related to the developing lower left third molar, which had apparently no communication with the oral cavity. ( info) |
65/162. Subperiosteal abscess of the orbit: an unusual complication of the third molar surgery. Few procedures in oral surgery show severe complications with the potential to result in life-threatening problems. Subperiosteal orbital abscess is an extremely rare but transcendent complication arising spontaneously or after dental surgery. This report describes a case of subperiosteal abscess of the orbit in a 57-year-old man that occurred following the uneventful extraction of the left maxillary third molar. In the emergency department, proptosis and extraocular muscle dysfunction were marked but no decrease in visual acuity was observed. Echography, computed tomography scan, and magnetic resonance imaging allowed distinction from other types of orbital inflammation. Surgical drainage confirmed the diagnosis. In this patient, orbital abscess was probably caused by extension of the infection to the pterygopalatine and infratemporal regions progressing next to the inferior orbital fissure. This report highlights the difficulty in the clinical diagnosis of this complication. ( info) |
66/162. cavernous sinus thrombosis following odontogenic and cervicofacial infection. cavernous sinus thrombosis (CST) is rarely seen clinically as a complication of infectious processes since the discovery of penicillin. At the present time, dental abscess is an uncommon cause of CST. We now report our experiences with a 60-year-old diabetic male, who developed CST 38 days after extraction of an infected upper third molar tooth. The importance of eradicating regional cervicofacial foci of infection is stressed. ( info) |
67/162. Orbital abscess of odontogenic origin. Case report and review of the literature. A case is discussed of a patient with an orbital cellulitis and a post septal abscess secondary to infection from an upper molar tooth. Spread of infection was to the maxillary sinus and thence to the orbit via a defect in the orbital floor. The clinical presentation, differential diagnosis, value of CT scanning, treatment and possible complications are reviewed. ( info) |
68/162. Intraoral etiology of a life-threatening infection in an immunocompromised patient: report of case. Oral infections are one of the major causes of morbidity and mortality in patients with hematologic malignancies. Total body irradiation and chemotherapy suppress the ability of the immune system to respond to the more virulent pathogens that can attack the compromised patient. The case of an 8.5-year-old girl is reported, in which an oral infection and a clinically observed motility resulted in a communication with the submandibular space; a significant hard, brawny edema of her right submandibular area resulted. Surgery, strict oral hygiene, and regular irrigation with a chlorhexidine gluconate solution resulted in successful healing. ( info) |
69/162. Cervical necrotizing fasciitis of odontogenic origin. Necrotizing fasciitis is a severe soft tissue infection caused by both aerobic and anaerobic bacteria and is characterized by a rapid extension along fascial planes and by necrosis of soft tissues. The disease rarely occurs in the head and neck. Three cases of necrotizing fasciitis of the neck after a dental infection are presented. The difficulty in diagnosing the early stage of this condition in relation to other soft tissue infections of odontogenic origin in the neck is discussed. The importance of an early diagnosis followed by an appropriate combination of medical, surgical, and dental treatment is emphasized. ( info) |
70/162. 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%. ( info) |