Injury to the teeth of succession by abscess of the temporary teeth.
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A case of a chronic odontogenic abscess that probably precipitated a frontopatrietal brain abscess by hematogenous spread has been presented. A thorough examination of the patient showed no other source of infection. Peptostreptococcus sp was found as the common pathogen despite 6 days of broad-spectrum antibiotic therapy. This case emphasizes the important role of dentistry in medical diagnosis and treatment implemented in the hospital setting.
OBJECTIVE: To present an unusual case of two uncommon cranial complications of frontal sinusitis: Pott's puffy tumor and epidural abscess arising from frontal sinusitis of dental origin, and also two systemic complications of sinusitis: septicemia and empyema, all occurring in an immunocompetent patient. STUDY DESIGN: A 21-year-old man presented with a scalp swelling and epidural abscess. Magnetic resonance imaging and computed tomographic scans revealed unilateral opacification of the frontal sinus and an epidural abscess with a direct connection to the scalp abscess. Further history revealed that his symptoms occurred coincidentally with a tooth extraction 2 months before, and he was hospitalized soon after the tooth extraction for sepsis and a lung abscess. METHODS: A combined neurosurgical and otolaryngologic approach was required to treat the sinusitis and the associated epidural and scalp abscess. RESULTS: Cultures returned as Streptococcus intermedius from all three sites. The patient was free of disease at the 3-month follow-up. CONCLUSIONS: Odontogenic maxillary sinusitis is well documented; however, there is little reported of frontal sinusitis arising from dental disease. The prevalence of sinusitis of dental origin will be reviewed, including the microbiology of this particularly virulent organism that persisted despite earlier treatment with ampicillin. Also, the current thoughts on management of these cases will be discussed with particular reference to local therapy for sinusitis in addition to systemic treatment with antibiotics.
Cysts and sinuses of the face and neck should always bring to mind the possibility of causative underlying dental disease. This should be investigated by history, physical examination and appropriate roentgenograms of the teeth. Abscesses of the teeth are the most common dental causes for the suspicious facial mass or sinus tract. Appropriate management includes extraction or root canal therapy of the diseases tooth. Any residual facial scar can later be excised and reconstructed as appropriate.
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An orbital abscess is a rare but serious complication of an odontogenic infection, which can lead to loss of vision or worse. This paper presents a case of orbital abscess secondary to an infection from the upper molar teeth, which extended to the retobulbar and posterosuperior region of the orbit, close to the superior orbital fissure. The infection spreaded to the pterygopalatine and infratemporal fossa and then to the orbit via the inferior orbital fissure. This paper reviews the clinical presentation, differential diagnosis, route of spread, value of serial CT scanning, treatment and possible complications.