Fatal complications in a patient with severe multi-space infections in the oral and maxillofacial head and neck regions: A case report

Abstract

BACKGROUNDOdontogenic infection is one of the common infectious diseases in oral and maxillofacial head and neck regions. Clinically, if early odontogenic infections such as acute periapical periodontitis, alveolar abscess, and pericoronitis of wisdom teeth are not treated timely, effectively and correctly, the infected tissue may spread up to the skull and brain, down to the thoracic cavity, abdominal cavity and other areas through the natural potential fascial space in the oral and maxillofacial head and neck. Severe multi-space infections are formed and can eventually lead to life-threatening complications (LTCs), such as intracranial infection, pleural effusion, empyema, sepsis and even death.CASE SUMMARYWe report a rare case of death in a 41-year-old man with severe odontogenic multi-space infections in the oral and maxillofacial head and neck regions. One week before admission, due to pain in the right lower posterior teeth, the patient placed a cigarette butt dipped in the pesticide "Miehailin" into the "dental cavity" to relieve the pain. Within a week, the infection gradually spread bilaterally to the floor of the mouth, submandibular space, neck, chest, waist, back, temporal and other areas. The patient had difficulty breathing, swallowing and eating, and was transferred to our hospital as an emergency admission. Following admission, oral and maxillofacial surgeons immediately organized consultations with doctors in otolaryngology, thoracic surgery, general surgery, hematology, anesthesia and the intensive care unit to assist with treatment. The patient was treated with the highest level of antibiotics (vancomycin) and extensive abscess incision and drainage in the oral, maxillofacial, head and neck, chest and back regions. Unfortunately, the patient died of septic shock and multiple organ failure on the third day after admission.CONCLUSIONOdontogenic infection can cause serious multi-space infections in the oral and maxillofacial head and neck regions, which can result in multiple LTCs. The management and treatment of LTCs such as multi-space infections should be multidisciplinary led by oral and maxillofacial surgeons.

Role of Telemedicine for Facio-Odontogenic Pain Management During COVID-19 Pandemic

“…Treatment includes Co-amoxyclav 625 (Amoxicillin 500 mg ? Clavulanic acid 125 mg) thrice a day, Metronidazole 400 mg 3 times a day and Ibuprofen 400 mg 3 times a day [12][13][14].…”

“…Non-life-threatening infections are generally not associated with fever and septicaemia. Treatment includes Co-amoxyclav 625 (Amoxicillin 500 mg + Clavulanic acid 125 mg) thrice a day, Metronidazole 400 mg 3 times a day and Ibuprofen 400 mg 3 times a day [ 12 – 14 ].…”

Etipatogenia, Diagnóstico E Tratamento Das Infecções De Origem Dentária: Revisão De Literatura

“…Dessa forma, Dai et al (2019), relatam que se essas infecções de origem dentária como periodontite periapical aguda, abscesso alveolar e pericoronarite não forem tratadas corretamente no seu estágio inicial, o processo infeccioso pode disseminar-se para outros órgãos, como o crânio, cérebro, cavidade torácica, cavidade abdominal. Portanto, essas infecções podem evoluir para complicações com risco de vida para o paciente, como infecção intracraniana, derrame pleural, empiema, sepse e até morte.…”

Fascial space odontogenic infections: Ultrasonography as an alternative to magnetic resonance imaging

“…Humans are affected by various diseases involving the maxillofacial region, many including the odontogenic infections commonly encountered in hospital practice. These infections are difficult to detect by the clinician and at times lead to life-threatening complications[ 3 , 4 ]. Some authors have suggested that abscesses should be drained and cellulitis treated with antibiotics, but others have suggested draining for both.…”