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A literature review of Toxic Shock Syndrome is presented, including epidemiology, etiology, signs, symptoms and management, and its relationship to infection susceptibility in the Down Syndrome patient. A case of a Down Syndrome patient with Toxic Shock Syndrome is described, and the role of odontogenic infection is discussed.
Möbius syndrome is a rare congenital disorder with the primary diagnostic criteria of congenital facial and abducent nerve palsy. Orofacial anomalies and limb malformations may be associated with the disorder. Involvement of other cranial nerves also is common. Occasionally, the V, X, XI, and XII cranial nerves are involved, resulting in difficulty of chewing, swallowing, and coughing, which often leads to respiratory complications. Mental retardation and autism have been reported in some cases. An 18-year-old Hispanic male came to the General Practice Residency clinic at the University of Illinois at Chicago for dental treatment. The patient had a history of Möbius syndrome, mental retardation, and behavioral problems. Because of acute situational anxiety and violent behavior, we arranged for the patient to have general anesthesia while we provided complete oral rehabilitation. This article discusses the treatment of a patient, including special considerations taken during anesthesia and dental management. A review of the special challenges concerning patients with such a condition are reviewed.
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A review is presented of 140 cases of acute dental pyogenic infections. The type of bacteria associated with these infections and their antibiotic sensitivity patterns are discussed and related to earlier reports. The incidence of antibiotic allergy, the principal contraindication to the use of certain antibiotics, has been assessed and appropriate alternative antibiotics are considered.
Endodontic cellulitis involves facial swelling which can vary from mild to severe and can occur as a primary case or a flare-up following initial treatment of asymptomatic teeth with periapical lesions. The microbial spectrum in primary cases involves a significant mixture of anaerobic and facultative aerobic microbes, chiefly streptococci. In a previous study, cultures from flare-up cases, utilizing the same anaerobic techniques as in primary cases, revealed an absence of obligate anaerobes and an 80 per cent incidence of facultative aerobic streptococci. These cases also revealed a significant time lapse from onset of symptoms to the cellulitis phase. No sex or age factors were noted in the primary or flare-up cases. The purpose of this case report is to restate a traditional theory, namely, the alteration of the oxidation/reduction potential (Eh), as a major factor for endodontic cellulitis flare-ups; to confirm the pathogenic potential of oral facultative streptococci; and that asymptomatic endodontic lesions tend to exist with mixed aerobic/anaerobic microbial flora.
BACKGROUND: Trismus and jaw pain are not only caused by temporomandibular disorders (TMD), but also by various pathologies, namely infection, trauma, or neoplasms. TMD-like symptoms, as a result of the pathologies, may be confusing to a clinician. This paper reports two cases of chronic dental infection mimicking TMD. METHODS: Two patients were initially diagnosed with, and treated for, TMD. However the patients did not respond to the treatment. Limited range of motion and jaw pain were then clinically evaluated for differential diagnoses. Laboratory examinations and computerized tomography (CT) scans were carried out to disclose any underlying lesion. RESULTS: Laboratory examination, such as, C-reactive protein helped to detect latent infection. CT scans revealed insidious chronic dental infection imitating TMD. Surgical drainage and chemotherapy resolved the symptoms. CONCLUSION: The importance of a rational diagnostic process, including clinical and laboratory examinations and radiologic imaging, cannot be over-emphasized in elucidating true cause of the symptoms.
Leuconostoc species are gaining importance as pathogenic organisms. We present the first case of odontogenic infection caused by Leuconostoc spp. Isolates initially identified as streptococci were found to be vancomycin resistant. Rigorous bacteriologic investigation subsequently classified these organisms as Leuconostoc mesenteroides.
While most bacteria involved in dentoalveolar infection are highly susceptible to penicillin, some Prevotella strains exhibit resistance to this agent through the production of beta-lactamase. The production of beta-lactamase by Prevotella spp. is in turn associated with the expression of the genes cfxA and cfxA2. The aim of the present study was to determine the prevalence of cfxA and cfxA2 in Prevotella strains by use of real-time PCR and to assess the performance of this molecular method for the direct detection of the genes in 87 clinical samples (pus and root canal exudates) from dentoalveolar infection. Production of beta-lactamase by each isolate was determined using a nitrocefin disk. beta-Lactamase production was seen in 31% of Prevotella isolates, while all isolates of other species were beta-lactamase negative. The penicillin resistance of isolates strongly correlated with the production of beta-lactamase. Real-time PCR was found to detect the cfxA and cfxA2 genes from at least five cells per reaction mixture (5 x 10(3) CFU/ml of pus). Using real-time PCR, the presence of cfxA and cfxA2 was evident for all 48 beta-lactamase-positive Prevotella strains. In contrast, neither beta-lactamase-negative Prevotella (n = 91) or non-Prevotella (n = 31) strains were positive for the genes. In this study, 31 of the 87 samples yielded beta-lactamase-positive Prevotella results, and cfxA and cfxA2 were detected in all 31 samples. Of the 56 culture-negative samples, 8 (14%) were positive for cfxA and cfxA2 by the real-time PCR. This sensitive and specific molecular method offers a rapid clinical test for aiding in the selection of an appropriate antibiotic for treatment of dentoalveolar infection. Although penicillin remains largely effective in the treatment of dentoalveolar infection, beta-lactamase-stable antibiotics should be considered in cases in which beta-lactamase-positive Prevotella strains are involved.
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The investigation of a high incidence of arthritis in 21 dairy herds disclosed elevated fluorine levels in bone samples. In every herd except one, where herbage and water was contaminated by industrial fall-out, the main source of the fluorine was from mineral supplements; In a few herds, purchased cake or grain balancers contributed to the abnormal levels. Over 100 cows with arthritis had fluroine levels in the bone of between 2000 and 8000 ppm, or were in herds whose diet contained excess fluorine. Characteristic tooth lesions often confirmed the link between arthritis and fluorosis. Sixteen out of 31 samples of mineral supplement contained dangerous levels of fluorine (3000 to 13000 ppm). Grain balancers contained up to 400 ppm F, and dairy cake had levels as high as 140 ppm F. There was a statistical correlation between a high incidence of damage to peri-articular structures, resulting in debility and loss of production, and elevated bone fluorine.
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Explore the source record for details and available documents.
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Explore the source record for details and available documents.