1/162. Pyorrhoea as cause of pyrexia. Three patients with fever and malaise, one of whom also had joint pains, were extensively investigated before their condition was attributed to dental sepsis. Each patient recovered fully after appropriate dental treatment. Dental sepsis should be added to the list of possible causes of pyrexia of undetermined origin, and a routine dental examination should be carried out in each case. ( info) |
2/162. Dental treatment of a prospective recipient of a liver transplant: a case report. A protocol to treat a carious condition in a young girl scheduled to receive a liver transplantation is described. Teeth with serious caries were filled with amalgam. Those teeth with pulp exposure were extracted. To stop bleeding, sutures and a surgical splint with a periodontal pack were used. All procedures were performed as rapidly as possible to minimize stress. Antibiotics were used sparingly. By improving the oral health of transplant recipients, the chances that the transplanted liver will become infected are much reduced, increasing the likelihood of a successful surgical outcome. ( info) |
3/162. 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. ( info) |
4/162. 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. ( info) |
5/162. 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. ( info) |
6/162. 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. ( info) |
7/162. 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. ( info) |
| 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. ( info) |
9/162. 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. ( info) |
10/162. An unusual case of a relationship between rosacea and dental foci. rosacea is a chronic disorder affecting the facial convexities, characterized by frequent flushing, persistent erythema, and telangiectases. During episodes of inflammation, additional features are swelling, papules, and pustules. The exact etiology of this dermatitis is unknown, and theories abound. Infectious foci, especially dental foci, seem to be rarely associated with the onset and progression of this disease. Dermatologic treatments are determined by the severity of the disease. But eradication of infectious foci, and in this case eradication of dental foci, may generate a significant improvement and may lead to a recovery. ( info) |