Immediate Versus Delayed Treatment of Odontogenic Infections

Author(s):  
2018 ◽  
Vol 1 (2) ◽  
pp. 15
Author(s):  
Joshua Sutikno

Background: Spinal cord injury (SCI), one of the problems caused by traffic accidents, has a high morbidity in developing country like Indonesia. In Indonesia, the use of motorcycles is increasing every year. The epidemiological data from Fatmawati Hospital of spinal cord injury in 2014 was 104 cases both traumatic and non-traumatic SCI. In this case, a young boy with worsening of SCI, delayed the treatment for about 3 months.Case: A 19 years-old male complained of limbs paralysis for the past two weeks. He felt numbness and tingling in hamstring and calf areas. From past medical history, he had a motorcycle accident 3 months prior. After the accident, he suffered from extreme low back pain, but he could still move his legs. Due to economic restrictions, the patient refused to go to the hospital, and they chose a traditional treatment. For about three months, the pain was decreasing, but he was never pain-free. As the symptoms continued to worsen, the neurosurgeon decided to decompress the spinal cord and performed discectomy. After a week of treatment, the pain disappeared, motor muscle got better, and he could feel again the sensation on the dermatome of S1. Conclusion: Early treatment is recommended to get a better outcome. The surgery is not the only treatment, rehabilitation and orthotics using are important too. Delayed treatment increases morbidity rate.


2011 ◽  
Author(s):  
John H. McDonough ◽  
Kerry E. Van Shura ◽  
Megan E. Lyman ◽  
Claire G. Eisner ◽  
Amelia Mazza ◽  
...  

2013 ◽  
Vol 01 (01) ◽  
pp. 001-003
Author(s):  
Aruna Singh ◽  
Nymphea Pandit ◽  
Monica Sharma

Abstract Aim- 1. The aim of this study was to investigate the average maximum range of inter-incisal mouth opening in a representative sample of the adult subjects of Haryana. 2. To see any correlation between maximal inter-incisal opening with age. Methods- Maximum mouth opening was studied in 756 adult subjects with age range of 20-50 years in Yamunanagar, Haryana. Age limit was further divided into three groups (20-30, 31-40, 41-50). Those with clinical history of TMJ involvement, OSMF, any trauma, odontogenic and non-odontogenic infections, dental prosthesis on the anterior teeth, congenital anomalies in the maxillofacial region were excluded from this study. The measurements were recorded twice and mean of the two values were taken. Statistical Analysis- Independent sample t-test was calculated to compare age and mouth opening in both male and females respectively. Bivariate pearson correlation was used to see any relationship between age and mouth opening. P-value ≤ 0.05 and CI (confidence interval) at 95% were considered statistically significant. The Results- The average mouth opening of males (45.36±6.70 mm) subjects was higher as compared to female (41.27 ± 6.75 mm) with significant, p-value 0.000. The mean mouth opening ± SD for both sexes combined was 43.39 ± 7.02 mm. The corresponding values for mean inter-incisal opening in male population aged 20-30, 31-40, 41-50 were 45.52 ± 7.15, 46.16 ± 5.47, 42.96 ± 6.82 mm and in female population aged 20-30, 31-40, 41-50 were 41.40 ± 7.08, 41.60 ± 6.29 and 40.03 ± 6.38 mm respectively. Conclusion- Maximal mouth opening differ significantly with gender. There is a decrease in MMO with older age group.


2021 ◽  
Vol 9 (6) ◽  
pp. 1307
Author(s):  
Sebastian Böttger ◽  
Silke Zechel-Gran ◽  
Daniel Schmermund ◽  
Philipp Streckbein ◽  
Jan-Falco Wilbrand ◽  
...  

Severe odontogenic abscesses are regularly caused by bacteria of the physiological oral microbiome. However, the culture of these bacteria is often prone to errors and sometimes does not result in any bacterial growth. Furthermore, various authors found completely different bacterial spectra in odontogenic abscesses. Experimental 16S rRNA gene next-generation sequencing analysis was used to identify the microbiome of the saliva and the pus in patients with a severe odontogenic infection. The microbiome of the saliva and the pus was determined for 50 patients with a severe odontogenic abscess. Perimandibular and submandibular abscesses were the most commonly observed diseases at 15 (30%) patients each. Polymicrobial infections were observed in 48 (96%) cases, while the picture of a mono-infection only occurred twice (4%). On average, 31.44 (±12.09) bacterial genera were detected in the pus and 41.32 (±9.00) in the saliva. In most cases, a predominantly anaerobic bacterial spectrum was found in the pus, while saliva showed a similar oral microbiome to healthy individuals. In the majority of cases, odontogenic infections are polymicrobial. Our results indicate that these are mainly caused by anaerobic bacterial strains and that aerobic and facultative anaerobe bacteria seem to play a more minor role than previously described by other authors. The 16S rRNA gene analysis detects significantly more bacteria than conventional methods and molecular methods should therefore become a part of routine diagnostics in medical microbiology.


Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 240
Author(s):  
Leanne Teoh ◽  
Monique C Cheung ◽  
Stuart Dashper ◽  
Rodney James ◽  
Michael J McCullough

Concerns regarding increasing antibiotic resistance raise the question of the most appropriate oral antibiotic for empirical therapy in dentistry. The aim of this systematic review was to investigate the antibiotic choices and regimens used to manage acute dentoalveolar infections and their clinical outcomes. A systematic review was undertaken across three databases. Two authors independently screened and quality-assessed the included studies and extracted the antibiotic regimens used and the clinical outcomes. Searches identified 2994 studies, and after screening and quality assessment, 8 studies were included. In addition to incision and drainage, the antibiotics used to manage dentoalveolar infections included amoxicillin, amoxicillin/clavulanic acid, cefalexin, clindamycin, erythromycin, metronidazole, moxifloxacin, ornidazole and phenoxymethylpenicillin. Regimens varied in dose, frequency and duration. The vast majority of regimens showed clinical success. One study showed that patients who did not receive any antibiotics had the same clinical outcomes as patients who received broad-spectrum antibiotics. The ideal choice, regimen and spectrum of empirical oral antibiotics as adjunctive management of acute dentoalveolar infections are unclear. Given that all regimens showed clinical success, broad-spectrum antibiotics as first-line empirical therapy are unnecessary. Narrow-spectrum agents appear to be as effective in an otherwise healthy individual. This review highlights the effectiveness of dental treatment to address the source of infection as being the primary factor in the successful management of dentoalveolar abscesses. Furthermore, the role of antibiotics is questioned in primary space odontogenic infections, if drainage can be established.


2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Jeff John ◽  
Ken Kesner ◽  
John Lazarus

Abstract Background Squamous cell carcinoma (SCC) of the scrotum was the first malignancy known to be associated with exposure to an occupational carcinogen—in this case, soot trapped in the breeches of chimney sweeps. Better civil rules and regulations and the replacement of hearths with other forms of heating have rendered SCC of the scrotum a rarity. We report two cases of scrotal SCC with vastly differing clinical presentations and management. Case presentation Case 1 had T1 N0 M0 disease and presented with a small (< 2 cm), innocuous-looking, non-healing ulcer of eight years duration. A punch biopsy revealed a superficially invasive SCC confirmed on immunohistochemical profiling. A wide local excision of the lesion was subsequently performed. Follow-up at three years showed no signs of recurrence. Case 2 presented with T4 N1 M1 disease and rapidly progressing locally destructive mass. A punch biopsy of the scrotal lesion confirmed invasive moderately differentiated focally keratinising SCC. The metastatic evaluation confirmed the presence of metastatic, extensive para-aortic lymphadenopathy. He was managed with cisplatin-based chemoradiotherapy. Conclusion Early detection and management of patients with SCC of the scrotum are essential. If the diagnosis is delayed, treatment options become limited, and the prognosis is poor. Notwithstanding the rarity of this disease, multicentre trials are needed to provide more precise guidelines as to the optimal management of these patients.


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