Difficult Cases of Odontogenic Deep Neck Infections: A Report of Three Patients

İsmi, Onur; Yeşilova, Mesut; Özcan, Cengiz; Vayısoğlu, Yusuf; Görür, Kemal

doi:10.4274/balkanmedj.2015.1379

Cited by 14 publications

(12 citation statements)

References 16 publications

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“…involved fascial space both in single and multiple fascial space infections. Also the current study is in agreement İsmi et al, 16 who reported that the second and third mandibular molar teeth are important sources of deep neck infections, because their roots extend to the junction of the mylohyoid muscle with the mandibular corpus adjacent to the submandibular and parapharyngeal spaces, making the submandibular space the most commonly involved area in this type of infections. Additionally Walia et al, 17 also reported the submandibular space to be the most commonly infected space.…”

Section: Discussionsupporting

confidence: 92%

Orofacial space infections, etiology, microbiological susceptibility and surgical management

Sulaiman¹,

Issa²,

Razzak³

2020

J Oral Res

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Orofacial infections are considered as one of most common infections and need rapid and adequate treatment as they affect a very delicate region and are associated with serious life-threatening complications. Orofacial infections can be either odontogenic that is with an origin in teeth and associated structures or non-odontogenic, not associated with teeth, can affect facial spaces and spread from one space to another, so a good knowledge about diagnosis and treating these infections is of utmost importance, and can include both non-surgical and surgical treatment. The aim of our study was to determine the most common cause of orofacial infections, the most common bacterial microorganisms and their antibiotic susceptibility. Materials and Methods: A descriptive study was undertaken in the Department of Oral and Maxillofacial Surgery, Al-Shaheed Ghazi Al-Hariry Hospital, Baghdad, Iraq from 1 st January to 30 th September 2015. This study included 45 patients with different forms of orofacial infections; data regarding age, gender, underlying cause, facial space involvement, presenting signs were collected through history, clinical examination and radiographs, incision and drainage with swab sample for culture and sensitivity test was performed. Results: Patients with orofacial infections showed a female to male ratio of 1.25:1. The mean age was 32.8 years. Most of the patients were in their 4 th decade of life (27%). Most infections were odontogenic in origin (62%), the most common facial space involved was submandibular (65%), the most common isolated microorganism was Streptococcus pyogenes (59%), and most patients were treated using an extra-oral surgical approach (78%). Antibiotics to which bacterial isolated showed the most sensitivity were netilmicin, cefoperazone and rifampicin (91%). Pain and limitation of mouth opening gradually decreased in most of patients during the two weeks follow up period. Conclusion: Orofacial infections were more common in females, in the third and fourth decade of life, were odontogenic in origin, were mostly caused by Streptococcus pyogenes, and most isolates were susceptible to netilmicin, cefoperazone and rifampicin. Pain and trismus decreased over two weeks post-treatment.

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Section: Discussionsupporting

confidence: 92%

Orofacial space infections, etiology, microbiological susceptibility and surgical management

Sulaiman¹,

Issa²,

Razzak³

2020

J Oral Res

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“…In the pre antibiotic era, several studies showed that most DNI cases (70-80%) resulted from complicated tonsillopharyngeal infections, whereas nowadays, the incidence has reduced (8-16%) though in children acute upper respiratory tract infection is the commonest cause, and odontogenic infection the next common cause. 18,19 The usual presentation in infants is various types of neck abscesses as it is difficult to make out the early clinical features. 20 The next common cause in our study was foreign body especially fish bone of the upper aero digestive tract (26.32%).…”

Section: Resultsmentioning

confidence: 99%

Deep neck space infections: comparison of outcomes between diabetic and non-diabetic patients

2021

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Background: The objective of the study was to study the clinical presentation, microbiological profile, treatment protocol of deep neck space infections in diabetics and non diabetics.Methods: This was a prospective study conducted on 76 patients (diabetics and non diabetics) admitted in the Department of Otorhinolaryngology, TD Medical college, Alappuzha over a period of 18 months from January 2012 to June 2013.Results: The age distribution was 15-75 years. Male to female ratio was 2:1. Fever, pain, neck swelling and odynophagia were the common symptoms with dyspnoea and chest pain indicative of complications. The most common etiology was odontogenic (68.4%) followed by tonsillopharyngeal infection and foreign bodies. No etiological factor was found in 34.2%. The commonest site was submandibular space (64.2%) followed by parapharyngeal space (26.6%). Abscess was present in majority needing surgical drainage. The most common organism isolated was streptococcus viridans (37.5%). Preponderance of klebsiella species was noted in diabetics. Streptococcus showed susceptibility to pencillin (83.33%), ampicillin (92%), cefotaxime (60.526%). Klebsiella showed susceptibility to gentamicin (42.3%) and ciprofloxacin (28.57%). The complication rate was more in diabetics (34.21%). Contrast enhanced CT was done in cases suspected to have complication. The mean hospital stay was longer in diabetics (19.6 days) than non diabetics (6.4 days).Conclusions: Deep neck space infection still remains life threatening if not heeded promptly. Senescence and diabetes demand surgical intervention and meticulous glycemic control to prevent complications. Judicious use of antimicrobials and timely radiological and surgical interventions have come a long way in the management and in providing a cure to this dreaded condition.

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“…Na TC do caso foi avaliado o velamento importante da região de seio maxilar a esquerda. Assim, para que não haja uma evolução do quadro clínico do paciente o tratamento prévio é essencial (Yuvaraj, 2016;Ismi et al, 2017;Uittamo et al, 2020).…”

Section: Discussionunclassified

Infecção odontogênica grave em paciente sistemicamente comprometida

Ardigueire

Mendonça

Santos

et al. 2021

RSD

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A infecção odontogênica é uma condição de saúde comum na clínica odontológica e pode representar em certas situações uma condição grave de saúde, com o potencial de disseminação por meio dos espaços fasciais da região de cabeça, pescoço e tórax, que necessitam de intervenções e tratamentos imediatos para não comprometer a vida do paciente. Algumas condições sistêmicas pré-existentes, como diabetes mellitus descontrolada, obesidade, alcoolismo e imunossupressão podem acentuar essas infecções. Neste relato de caso, apresentamos uma paciente de 24 anos de idade com uma infecção odontogênica severa, disseminada em hemiface esquerda, apresentando diabetes mellitus e hipertensão arterial sem tratamento, sendo atendida em ambiente hospitalar. Paciente apresentou dor exacerbada, disfagia e trismo. Ao exame intrabucal revelou higiene oral insatisfatória, limitação da abertura bucal acentuada, ausência do elemento 28, dente 38 apresentando pericoronarite e sinais de mordiscamento na mucosa jugal esquerda em virtude do edema. Aos exames laboratoriais alterações significativas foram constatadas. Foi iniciada antibioticoterapia intravenosa instituída pela equipe médica de Meropenem 3 vezes ao dia e Vancomicina duas vezes ao dia. Optou-se como tratamento a exodontia do foco infeccioso, drenagem de exsudato purulento via alveolar, irrigação abundante e aspiração de soro fisiológico 0,9%. Após melhora do quadro clínico, laboratorial e controle do estado glicêmico da paciente, a mesma recebeu alta hospitalar com controle ambulatorial periódico. Em ambulatório a paciente apresentou melhora em seu quadro, regredindo o aumento volumétrico e com leve endurecimento em face. Segue aos cuidados sistêmicos em ambulatório pela equipe médica. Deste modo, a infecção em pacientes com comprometimento sistêmicos, requer uma abordagem imediata e multiprofissional para garantir um bom prognóstico.

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Difficult Cases of Odontogenic Deep Neck Infections: A Report of Three Patients

Cited by 14 publications

References 16 publications

Orofacial space infections, etiology, microbiological susceptibility and surgical management

Orofacial space infections, etiology, microbiological susceptibility and surgical management

Deep neck space infections: comparison of outcomes between diabetic and non-diabetic patients

Infecção odontogênica grave em paciente sistemicamente comprometida

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