21/162. Are dental infections a cause of brain abscess? Case report and review of the literature. Dental pathology and/or treatment have been linked to a small number of brain abscesses as possible sources of infection. A further case is presented, in which a dental site is implicated. A review of the evidence was undertaken. A wide range of dental procedures had been implicated. In some cases the brain isolate was not of dental origin. In many, the diagnosis was one of exclusion. In order to confirm the role of odontogenic infection in the pathogenesis of brain abscess, modern sampling techniques should be used to precisely identify the isolates. The causal organism should be identified in both oral and cranial sites. ( info) |
22/162. mortality associated with odontogenic infection! Odontogenic causes are the most common source for spreading maxillo-facial infections. These infections can develop into life threatening events. However a fatal outcome is fortunately rare and is generally associated with an immunocompromised status. This case report highlights a spreading maxillo-facial infection, which resulted in massive haemorrhage from the subclavian vein into the pleural cavity and subsequent death of a young fit male patient. ( info) |
23/162. Subdural empyema secondary to odontogenic masticator space abscess: detection by indium-111-labeled white cell scan. Subdural empyema (SDE) is an extremely rare but serious complication of dental infection. A case is presented in which dental infection was complicated by a masticator space abscess and eventually led to a SDE. This report illustrates a rare sequence of events leading to SDE and its serendipitous detection by indium-111-labeled leucocyte scan. ( info) |
| Deep neck infections are a rare but potentially fatal complication of pulpal abscess of the teeth. If an infection can progress rapidly from a toothache to a life-threatening infection, then it is critical that dentists be able to recognize the danger signs and identify the patients who are at risk. This article reviews a case of a seemingly innocuous toothache which rapidly progressed to ludwig's angina and mediastinitis, and discusses how to recognize and manage these life-threatening infections. ( info) |
25/162. Odontogenic subperiosteal abscess of orbit: a case report. Subperiosteal abscess of orbit is an uncommon but serious complication of orbital infection. We report a case of a 78 year old gentleman who presented with bilateral periorbital oedema and proptosis. Computerised tomography of orbit revealed bilateral dilated superior ophthalmic veins. Bilateral carotid-cavernous fistula was initially suspected. Serial imaging showed an increasing bilateral subperiosteal lesion of the orbit. Fine needle aspiration confirmed subperiosteal abscess. A high level of awareness is necessary in diagnosing subperiosteal abscess. ( info) |
26/162. Staphylococcal submandibular lymphadentitis of childhood. The presentation of two patients with the condition is described. The difficulty of finding an underlying cause of the infection is discussed, and the importance of a history of recent head and neck infection emphasised. Recommendations are made for appropriate antibiotic therapy to cover Staphylococci as well as the more common Streptococci. ( info) |
| Necrotizing fasciitis is a rapidly spreading, life-threatening, bacterial disease. mortality rates have been estimated to vary between 8.7% and 74%. mortality depends on many factors, one of which is early recognition. Necrotizing fasciitis of dental origin has a low prevalence and as such presents diagnostic challenges for the dentist. The literature is reviewed, and a case history is presented. ( info) |
| We report two cases of septic pulmonary embolism associated with periodontitis. Chest CT revealed multiple nodular shadows with features characteristic of septic pulmonary embolism in both patients. Both patients had toothache, fever, and chest pain, and showed findings of periodontitis at initial presentation. Antimicrobial agents combined with dental surgery were successful in treatment. While septic pulmonary embolism from the lesions of periodontitis appears to be rare, periodontitis remains important in the differential diagnosis of septic pulmonary embolism. ( info) |
| diabetic ketoacidosis (DKA) is a medical emergency with a potentially fatal outcome if not recognized and treated appropriately. Infective processes are a common precipitant of DKA. We report two cases of dentoalveolar infections in patients with type I diabetes mellitus who presented with DKA. The management of such cases requires both specialist surgical and medical intervention. ( info) |
30/162. Potentially fatal oro-facial infections: five cautionary tales. Five cases of oro-facial infection leading to life-threatening complications are reported. Although all had been treated with antibiotics prior to maxillofacial referral, lack of surgical intervention had allowed progressive infection. The importance of resuscitation, supportive therapy, extraction of involved teeth to remove the source of infection and drainage of pus is emphasised ( info) |