Odontogenic orbital abscess with intracranial and pulmonary involvement

Abstract

A 58-year-old woman presented to the emergency department with left ptosis and complete ophthalmoplegia. Imaging demonstrated a left orbital abscess. Her past medical history included cavitatory lung disease and "aseptic" meningitis 2 months previously. An anaerobic organism and commensal of the oral flora, Peptostreptococcus sp., was cultured from the orbital abscess. The patient was found to have a carious upper molar with chronic buccal abscess, which was extracted. This case presents an uncommon pathogen arising from an odontogenic infection as the etiology for orbital abscess, cavitatory lung disease, and meningitis in one patient.

Rare brain and pulmonary abscesses caused by oral pathogens started with acute gastroenteritis diagnosed by metagenome next-generation sequencing: A case report and literature review

“…Like in our case, they did not get positive culture results from a respiratory tract specimen. The recovery of the patient's cavitatory pulmonary lesions and aseptic meningitis after intravenous antibiotics strongly supports an infectious etiology (Hughes et al, 2017). In addition, the route and mechanism of oral microbiome invading the brain and lung is unknown and needs to be clarified.…”

Orbital Abscess—Two Case Reports with Review

“…Exact results were not presented in 14% of cases. Fortunately, any patient died in the investigated reports [3,8]- [28,30,32]- [39,42]. ( Table 3) Author Contributions All authors contributed equally to the publication.…”

“…The most frequently encountered signs and symptoms include periorbital edema, restricted ocular movement, orbital pain, proptosis, periorbital erythrema, chemosis and vision deterioration- Table 1. [3,8]- [39] Etiology Bacterial etiology is the most common and regards pathogenes such as Streptococcus spp. [7,11,14,16,28,31,33,35,39,40], Staphylococcus aureus [9,36,40] (also methycylin resistant Staphylococcus aureus [20,21,34,40]) and Pseudomonas aeruginosa [24,30,41].…”

“…[28,39], Coagulase-negative staphylococcus [23,40], Peptostreptococcus spp. [8,27], Citrobacter freundii [11,40], Enterobacter spp. [40], Enterococcus spp.…”

“…They claimed hematogenous spread of the infection, because maxillary sinus showed no infection. [8] Imaging Ocular ultrasonography provides immediate assessment of an orbit and opportunity to follow treatment outcomes without unnecessary exposure to radiation [20,21]. However, more accurate examinations such as CT or MRI are crucial to evaluate local extension and involvement of adjacent structures, especially before surgical treatment.…”