A fatal case of empyema thoracis: the price for underestimating odontogenic infections

Abstract

a b s t r a c t Most dental infections are often underestimated by both patients and professional health care givers. When poorly managed, odontogenic infections may result in serious morbidity and life-threatening conditions. This article reports a fatal case of empyema thoracis in a 16-year-old male after an odontogenic infection. The challenges of management in our environment are discussed. Furthermore, the importance of understanding the route of spread after odontogenic infections is highlighted. Ó 2015 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

Empyema thoracis of odontogenic origin: experience from a maxillofacial unit

“…The absence of side predilection could also be an indicator of rarity of the condition. Earlier Nigerian cases had chest tube insertion on the right side [5] and on the left side [3]. Three of the five patients (60%) in our series had chest tube insertion on the right side.…”

“…The median initial volume of pus recorded in our patients was 1,000 ml. Lower volumes (400 ml and 650 ml) were reported by Agbara et al [3] and Glen and Morison [9], but a higher volume (1,800 ml) has also been…”

“…Previous reports indicate that thoracic complications of odontogenic infections have no age preference. Nigerian cases [3][4][5] have been young adults; all our five patients were between 21-29 years old. Most cervicofacial infections that descend into the neck and chest are caused by tooth infections, especially dental and periodontal abscesses [2,6].…”

“…The present series of five cases is the highest ever published to our knowledge. The total number of reported cases of empye ma thoracis from our center is now 7 [3,5].…”

“…Descending neck infections are rarely complicated by empyema thoracis. The outcome of this complication depends on early diagnosis and aggressive treatment [3]. However, there are few case series on the pattern of presentation and the treatment of complication from a resource-constrained environment.…”