Microbiological Approach in Management of Recurrent Dento - Buccal Space Infection - Report of Three Uncommon Cases

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Pavithra D ◽  
◽  
Keerthinarayanan . ◽  
Satish Kumar CSC ◽  
Archana B ◽  
...  
Keyword(s):  
Systemic Disease ◽  
Complete Recovery ◽  
Klebsiella Pneumonia ◽  
Odontogenic Infections ◽  
Neck Infection ◽  
Space Infection ◽  
Odontogenic Origin ◽  
Empiric Antibiotic ◽  
Buccal Space ◽  
Relationship Factors

The route of facial infection usually depends on the jaw-tooth relationship factors followed by virulence and type of microorganisms. Staphylococci are frequently associated with abscess formation. However, at times head and neck infection with an odontogenic origin are caused by gram-negative species like Klebsiella pneumonia without any predisposing opportunistic infectious etiology. In this report, we presented 3 rare cases of buccal space infection associated with Klebsiella pneumonia without any predisposing systemic disease. Appropriate diagnosis followed by antibiotics oral cephazolin (500mg BID) and intra-muscular gentamicin (150mg BID) at adequate strength and duration has brought a significant decrease in the progression of the disease that yielded complete recovery after 10days. Thus with odontogenic infections it is appropriate to always begin with the empiric antibiotic regimen with correlation to clinical presentation thinking of the most likely suspected microorganisms, which are usually the normal flora of the region, without forgetting the importance of early surgical intervention to reduce morbidity and complications.

scholarly journals Evaluation of the Involvement of Facial and Cervical Spaces in Odontogenic Infections in Patients Referred to Shahid Rahnemoon Hospital from 2014 to 2018

2020 ◽  
Vol 9 (40) ◽  
pp. 2960-2964
Author(s):  
Mohsen Barzegar ◽  
Amir Vaghefi ◽  
Adele Pouyafard ◽  
Seyed Mojtaba Alavikia
Keyword(s):  
Statistical Tests ◽  
Systemic Disease ◽  
Cross Sectional Study ◽  
Mean Body Temperature ◽  
Cross Sectional ◽  
Odontogenic Infections ◽  
Source Of Infection ◽  
The Mean ◽  
Buccal Space ◽  
Age Range

BACKGROUND Odontogenic infections are recognized as one of the most common diseases in the world. Organisms that cause dental infection and are a part of the oral normal flora include dental plaque bacteria, mucosal surface bacteria, and gingival bacteria. This study aimed to investigate the prevalence of odontogenic infections by involving the facial and cervical spaces in patients referred to Shahid Rahnemoon Hospital from 2014 to 2018. METHODS This was a descriptive cross-sectional study. The sampling method was census and 308 patients with all types of odontogenic infections associated with the involvement of the facial and cervical spaces referred to Shahid Rahnemoon Hospital from 2014 to 2018 were included in the study. Questionnaire was used for data collection. The data was entered into SPSS version 23 software and analysed using statistical tests. RESULTS The mean age of participants was 31.10 ± 14.48; the mean number of hospitalization days was 4.83 ± 2.52 days; the mean body temperature was 37.45 ± 0.54. Of the 308 patients studied, 221 (71.8 %) had no history of systemic disease. Also, 294 (5 %) had no airway involvement. The most commonly prescribed antibiotic was penicillin + metronidazole with a frequency of 54.9 %, The most common tooth that was the source of infection was mandibular tooth no. 6 with a frequency of 22.7 %, the most common type of treatment was incision + drainage + antibiotic therapy with a frequency of 44.2 %; the most common involved area was the submandibular + buccal space with a frequency of 20.1 % and the most common age range of involvement was 20 - 29 years. CONCLUSIONS In odontogenic infections, penicillin + metronidazole is the most commonly used antibiotic and buccal + submandibular space is the most common area involved. KEY WORDS Odontogenic Infection, Facial Spaces, Cervical Spaces

scholarly journals Bilateral canine space infection secondary to odontogenic origin. A rare case report.

2019 ◽  
Vol 6 (4) ◽  
pp. 129-132
Author(s):  
Mayur Janardan Gawande ◽  
Mithilesh Kumar Gupta ◽  
Manu Goel
Keyword(s):  
Surgical Management ◽  
Early Recognition ◽  
Panoramic Radiograph ◽  
Etiological Factors ◽  
Odontogenic Infections ◽  
Space Infection ◽  
Rare Case Report ◽  
Odontogenic Origin ◽  
Success Of Treatment

Odontogenic infections (OI) are a major reason for consultation in dental practice. They affect people of all ages, and most of them respond well to current medical and surgical treatments. The aim of this paper is to emphasize different and rare etiological factors that can play a role in odontogenic abscesses, which can lead to complications. A 54-year-old man complaints of pain and swelling on the upper front-side of his face. Physical examination of the face showed enlargement and swelling in the upper front region. Panoramic radiograph images showed a radiolucent appearance of the canine region. Based on the results of the clinical and radiographic examinations, the patient was diagnosed with a bilateral canine space infection. The treatment performed was FNAC (Fine neddle aspiration cytology) from canine region followed by intraoral drainage incision at the most prominent part of swelling (Modified Hiltons method), 5 ml of pus was removed, postoperative dressing was applied and regular follow-up was done with continued antibiotic therapy. Bilateral canine space abscess is a rare odontogenic infection that can cause life-threatening complications. The success of treatment requires early recognition, determination of etiological factors, and appropriate medical and surgical management. To perform treatment of odontogenic infections, the Oral & Maxillofacial Surgeon should understand the terminology regarding infectious diseases and pathophysiology. The success of treatment requires early recognition, determination of etiological factors, and appropriate medical and surgical management.

Epidemiologic evaluation of maxillofacial infections and their risk factors and associated complications in a one year period in Shariati hospital in 2013-2014

2019 ◽  
Author(s):  
Hamid Mahmood Hashemi ◽  
Reza Sharifi ◽  
Mahboube Hasheminasab ◽  
Mostafa Mortazavi
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Demographic Data ◽  
Systemic Disease ◽  
Maxillofacial Surgery ◽  
Severe Infection ◽  
Oral And Maxillofacial Surgery ◽  
Odontogenic Infections ◽  
Buccal Space ◽  
Maxillofacial Infections

Purpose: Maxillofacial infections (MIs) commonly occur in patients of all ages, representing a life-threatening challenge when reaching deep facial spaces. The epidemiologic studies of MIs and their characteristics are very important and beneficial for both patients and clinicians. Therefore, the aim of this prospective study was to determine the annual incidence, etiology, risk factors and complications of MIs in all patients who were admitted to the department of oral and maxillofacial surgery of the Shariati hospital during a 1-year period. Material and methods: The demographic data, levels of some serum markers on day of admission, such aserythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), bandemia, serum albumin, predisposing factors for each patient referred for treatment of MI were recorded by one researcher in November 2013 to November 2014. The linear regression test was used to evaluate whether there was a relationship between the amount of changes in ESR, CRP and albumin levels and age of the patients, pregnancy, gender and severity of infection. Panoramic radiography as well as axial and coronal CT scans with soft tissue window were performed for all cases, except pregnant participants. The origin of MIs, including odontogenic, pathologic and foreign body, was identified for each patient. Results:During the study period, a total of 157 patients (87 female, 70 male), with an age range of 3 to 74 years (mean, 23.5±13.2 years), were admitted to the department of maxillofacial surgery. Regardless of the gender, the most frequent cause of MIs was odontogenic sources (128 cases, 81.5%). The most common affected area was the buccal space with 106 positive cases (67.5%). The most common teeth responsible for maxillofacial fascial space infection were mandibular third molars. A positive association was found between CRP and ESR levels and the severity of infections. Serum albumin and ESR levels were significantly reduced and increased in the patients with severe infection and pregnant patients, respectively. Conclusion: The results of this study indicated that odontogenic origins were the main cause of MIs and the most common involved space was the buccal space. Diabetes mellitus was the most commonly found systemic disease among the participants of this study. The findings of this study suggest that dentists should consider that the most appropriate treatment of odontogenic infections involves surgical intervention and selection of a suitable antibiotic as an adjunct.

scholarly journals Microbiology and Antibiotic Sensitivity of Odontogenic Space Infection

2014 ◽  
Vol 3 (1) ◽  
pp. 303 ◽  
Author(s):  
A. N. Santosh ◽  
A. N. Viresh ◽  
B. K. Sharmada
Keyword(s):  
Clavulanic Acid ◽  
Anaerobic Bacteria ◽  
Complex Mixture ◽  
Antibiotic Sensitivity ◽  
Coagulase Negative Staphylococci ◽  
Odontogenic Infections ◽  
Space Infection ◽  
Odontogenic Space Infection ◽  
Life Threatening ◽  
Buccal Space

<p><strong>Background:</strong> Dental infections, including gingivitis, odontogenic infections periodontitis, dental caries and, result in frequent dental visits. Infection can be mild buccal space infection or severe life threatening multi space infection.</p><p><strong>Objectives:</strong> To appraise causative microorganisms responsible for odontogenic space infections and to evaluate sensitivity and resistance to antibiotics used in the treatment.</p><p><strong>Materials and Methods:</strong> 90 patients with orofacial space infections were considered. Pus samples were collected with aseptic precautions and examined in the department of microbiology for culture and antibiotic sensitivity.</p><p><strong>Results:</strong> Aerobic organisms were highly sensitive to Ceftriaxone 95.2%, Levofloxacin 90.5% and Amoxicillin and Clavulanic acid for 81% and were resistance to Ampicillin and Cefaclor 47.6%. Anaerobic organisms were 100% resistance to Ampicillin and were 100% sensitive to Cephalothin, Cephalexin, Gatifloxacin, Linezolid and Tazact. 91.7% were sensitive to Amoxicillin and Clavulanic acid. Ampicillin resistance was seen in 47.6% of aerobes and 100% of the anaerobes.</p><p><strong>Conclusion:</strong> This study confirms that the microbiological flora of odontogenic infections consists of complex mixture of aerobic and anaerobic bacteria. The microorganisms isolated were Streptococcus viridians, Klebsiella, Pseudomonas aeruginosa, and Coagulase negative Staphylococci. Most common anaerobic organisms were Peptococci and Peptostreptococci. Amoxicillin/Clavulunic acid and Cefotaxime were most effective antibiotics.</p>

scholarly journals Deep Neck infections of Odontogenic Origin and Their Clinical Significance. A Retrospective Study from Hradec Králové, Czech Republic

2015 ◽  
Vol 58 (3) ◽  
pp. 86-91 ◽  
Author(s):  
Helena Doležalová ◽  
Josef Zemek ◽  
Luboš Tuček
Keyword(s):  
Diabetes Mellitus ◽  
Economic Status ◽  
Statistical Significance ◽  
Systemic Disease ◽  
University Hospital ◽  
Airway Patency ◽  
Significance Level ◽  
Socio Economic Status ◽  
Odontogenic Origin ◽  
The Mean

Introduction: Cellulitis remains a very serious disease even today. Mortality, which varied between 10–40%, has been reduced owing to the standard securing of airway patency and use of an appropriate surgical treatment approach. Materials and methods: A total of 195 patients were hospitalised for cellulitis at the University Hospital in Hradec Králové during 2007–2011. The following parameters were evaluated: age, gender, dependence of incidence of the disease on the season of the year, frequency of attacks of the particular areas and their clinical characteristics, aetiology of the inflammation, types of patient complaints, prevalence of current systemic diseases, results of microbiological and selected laboratory analyses, socio-economic status of the patients, and duration of patient stay at the hospital. Statistical analysis was performed by using Pearson’s correlation coefficient, the statistical significance level was p < 0.05. Results: The mean age of the patients was 39.8 years. The group of 195 patients included 108 (55%) males and 87 (45%) females. The mean time between the first symptoms of the disease and admission to the Department was 5 days. From among the 195 patients, 116 (59.5%) were working persons, 79 (40.5%) were non-working (children, students, unemployed persons, women on maternity leave, retired people). The odontogenic origin of the disease was verified in 173 (88.7%) patients. In total, 65 (33.3%) patients had no coinciding complicating systemic disease, 22 (11.3%) patients had diabetes mellitus. The most frequent symptom of cellulitis was painful swelling, found in 194 (99.5%) patients, followed by jaw contracture, found in 153 (78.5%) patients. Conclusion: The results are largely very similar to those of previous studies performed in other countries, except that we found no correlation between the prevalence of cellulitis and the socio-economic status, nor have we confirmed Klebsiella pneumoniae sp. as the cause of cellulitis in patients with diabetes mellitus.

scholarly journals Extraoral Sinus Tracts of Odontogenic Origin: A Case Series

2020 ◽  
Author(s):  
Ellahe Azizlou ◽  
Mohsen AminSobhani ◽  
Sholeh Ghabraei ◽  
Mehrfam Khoshkhounejad ◽  
Abdollah Ghorbanzadeh ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Case Series ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
Cutaneous Lesions ◽  
Odontogenic Origin ◽  
The Face ◽  
History Of ◽  
Relationship Of ◽  
Dental Infections

Extraoral sinus tracts of odontogenic origin often develop as the result of misdiagnosis of persistent dental infections due to trauma, caries, or periodontal disease. Due to these lesions' imitation from cutaneous lesions, misdiagnosis, and mismanagement, which we frequently encounter, this article aims to describe four cases with manifestations in different parts of the face and the neck. Patients were referred to an endodontist with a history of several surgical procedures and/or antibiotic therapy due to misdiagnosis. After comprehensive examinations, root canal treatment was performed. The resolution of signs and symptoms during the follow-up period confirmed the correct diagnosis. Dermatologists and other physicians should be aware of the possibility of the relationship of extraoral sinus tracts with dental infections. Precise examination and taking a comprehensive history can aid to prevent unnecessary and incorrect therapeutic and/or pharmaceutical interventions. Elimination of dental infection leads to complete recovery in such patients.

scholarly journals Hyperbaric oxygen therapy in a case of cervical abscess extending to anterior mediastinum, with isolation of Prevotella corporis

2019 ◽  
Vol 12 (7) ◽  
pp. e229873 ◽  
Author(s):  
Francesco Ciodaro ◽  
Francesco Gazia ◽  
Bruno Galletti ◽  
Francesco Galletti
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Combined Treatment ◽  
Complete Recovery ◽  
Anterior Mediastinum ◽  
Multidisciplinary Teams ◽  
Odontogenic Infections ◽  
Odontogenic Abscess ◽  
Descending Mediastinitis

We present a case of an odontogenic abscess, first spreading at the lateral cervical level and then in mediastinum. We isolated an anaerobic bacterium, Prevotella corporis, rarely documented in literature. The mortality rates of cervical abscesses secondary to odontogenic infections and complicated by mediastinitis vary from 10% to 40%. Treatment of descending mediastinitis involves multidisciplinary teams such as otorhinolaryngology, thoracic surgeons, infectious disease physicians, anesthetists and intensivists. Due to the combined treatment with surgical drainage within 48 hours of hospitalisation, antibiotics and subsequent hyperbaric oxygen therapy, we have achieved complete recovery of the patient.

scholarly journals Multidisciplinary treatment of deep neck infection associated with descending necrotizing mediastinitis: a single-centre experience

2019 ◽  
Vol 47 (12) ◽  
pp. 6027-6040 ◽  
Author(s):  
Chao Ma ◽  
Lian Zhou ◽  
Ji-Zhi Zhao ◽  
Run-Tai Lin ◽  
Tao Zhang ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Multidisciplinary Treatment ◽  
Multiple Organ ◽  
Deep Neck Infection ◽  
Descending Necrotizing Mediastinitis ◽  
College Hospital ◽  
Odontogenic Infections ◽  
Neck Infection ◽  
Medical College ◽  
Mediastinal Drainage

Objective Deep neck infection (DNI) associated with descending necrotizing mediastinitis (DNM) is a highly lethal condition. This retrospective review was performed to share our experience performing multidisciplinary management of DNI associated with DNM during a 7-year period. Methods We reviewed 16 patients who had been surgically treated for DNM at Peking Union Medical College Hospital from April 2010 to July 2017. The clinical outcomes were analysed to determine the most appropriate therapeutic strategy. Results Five women and 11 men were included in this study. Their mean age was 54.9 ± 14.3 years. DNM-associated infections most commonly occurred secondary to odontogenic infections (n = 10). Thirteen patients required tracheotomy because of tracheal compression. All patients underwent unilateral or bilateral cervicotomy. Six patients with DNM localized in the upper mediastinal space underwent transcervical mediastinal drainage, while 10 patients with DNM extending to the lower mediastinum were treated by cervicotomy and video-assisted thoracoscopic surgery. Three patients died of multiple organ failure. Conclusion Multidisciplinary treatment can achieve favourable outcomes in >80% of patients with DNM. Early diagnosis, proper airway management, and adequate surgical drainage are crucial for reducing mortality in patients with DNM, and minimally invasive procedures also play an important role.

Odontogenic Infections with Cutaneous Involvement in Children: a Case Series

Dental Update ◽  
2020 ◽  
Vol 47 (2) ◽  
pp. 144-148
Author(s):  
Joana Monteiro ◽  
Adèle Johnson ◽  
Pathanjali Kandiah ◽  
Prabhleen Anand ◽  
Stephen Fayle
Keyword(s):  
Case Series ◽  
Well Being ◽  
Skin Lesions ◽  
Diagnostic Dilemma ◽  
Odontogenic Infections ◽  
Cutaneous Involvement ◽  
Odontogenic Origin ◽  
Oral Symptoms ◽  
The Uk ◽  
Dental Professionals

Cutaneous involvement of dental sepsis is a rare occurrence in children. It often presents as a diagnostic dilemma, especially in the absence of oral symptoms, with initial presentation to non-dental professionals. This article discusses three cases of children presenting with cutaneous involvement of odontogenic origin to two paediatric dentistry departments in the UK. All cases had delayed presentations and were initially submitted to ineffective treatment, with significant impact on the children’s well-being. Final management included antibiotic therapy, drainage and extraction of the septic tooth. These three cases highlight the importance of considering a dental aetiology for localized inflammatory and purulent skin lesions of the mandible. Prompt diagnosis and early treatment are determinant for early resolution and avoidance of systemic or psychological complications. CPD/Clinical Relevance: This article discusses diagnosis and management of three different presentations of odontogenic sepsis with cutaneous involvement in children.

scholarly journals Spread of odontogenic infections in the elderly: Prevalence and characteristic multidetector CT findings

2017 ◽  
Vol 4 (1) ◽  
pp. 28 ◽  
Author(s):  
Ichiro Ogura ◽  
Norihito Iizuka ◽  
Marie Ishida ◽  
Eri Sawada ◽  
Takashi Kaneda
Keyword(s):  
Elderly Patients ◽  
Odds Ratio ◽  
Multivariate Regression ◽  
Multidetector Ct ◽  
The Elderly ◽  
Multivariate Regression Analysis ◽  
Masticator Space ◽  
Odontogenic Infections ◽  
Submandibular Space ◽  
Buccal Space

Purpose: To analyze spread of odontogenic infections in the elderly, especially the prevalence and characteristic multidetectorcomputed tomography (MDCT) findings.Materials and methods: Ninety-seven patients with odontogenic infection who underwent 64-row MDCT were evaluated inthis study. The study patients comprised 31 elderly patients (60 years) and 66 adults (< 60 years). Age, gender, location ofcausal tooth, and spread of odontogenic infections with MDCT were analyzed.Results: The elderly patients (74.2%) had higher ratio with female compared to the adults (57.6%). The buccal space (93.5%)was the most common spread of odontogenic infections for the elderly patients, followed by the masticator space (54.8%) andsubmandibular space (45.2%), whereas the buccal space (97.0%) was the most common spread of odontogenic infections for theadults, followed by submandibular space (65.2%) and masticator space (51.5%). Logistic multivariate regression analysis forodontogenic infections in the elderly demonstrated that the gender (odds ratio = 3.462, P = .024) and submandibular space (oddsratio = 0.168, P = .013) were significant variable.Conclusions: The study showed the prevalence and characteristic MDCT findings of spread of odontogenic infections in theelderly.

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