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Swain S, Lenka S, Jena P. Deep neck abscess: Our experiences at a tertiary care teaching Hospital of Eastern India. MATRIX SCIENCE MEDICA 2022. [DOI: 10.4103/mtsm.mtsm_15_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Weerasinghe D, Lueck CJ. Septic Cavernous Sinus Thrombosis: Case Report and Review of the Literature. Neuroophthalmology 2016; 40:263-276. [PMID: 27928417 DOI: 10.1080/01658107.2016.1230138] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 08/25/2016] [Accepted: 08/25/2016] [Indexed: 10/20/2022] Open
Abstract
Septic cavernous sinus thrombosis is a rare but serious complication of infection of the cavernous sinuses. There are no randomised, controlled trials of management of this condition and existing reviews of the literature are somewhat dated. The authors report a case with a favourable outcome and then present the findings of a literature review of the management of this condition. Outcome data suggest that corticosteroids are of equivocal benefit whereas antibiotics and anticoagulation are beneficial.
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Affiliation(s)
- Dinushi Weerasinghe
- Department of Neurology, The Canberra Hospital and Australian National University Medical School , Canberra, Australia
| | - Christian J Lueck
- Department of Neurology, The Canberra Hospital and Australian National University Medical School , Canberra, Australia
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Shefelbine SE, Mancuso AA, Gajewski BJ, Ojiri H, Stringer S, Sedwick JD. Pediatric retropharyngeal lymphadenitis: Differentiation from retropharyngeal abscess and treatment implications. Otolaryngol Head Neck Surg 2016; 136:182-8. [PMID: 17275536 DOI: 10.1016/j.otohns.2006.03.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2005] [Indexed: 11/19/2022]
Abstract
Objectives Our objectives were to review the retropharyngeal anatomy, define retropharyngeal adenitis and abscess, and determine if CT may guide the clinician in treatment planning for pediatric retropharyngeal infections. Study Design and Setting A retrospective chart review and CT scan review of 30 children with retropharyngeal infections. Results All patients had retropharyngeal adenitis. Average volume of the low-attenuation focus in the medical treatment group was 1.2 cm3. Average volume in the surgical group was 4 cm3. Surgery patients with no purulent findings were then grouped with the medical treatment group; the average volume of the low-attenuation focus in this group was 2.2 cm3. Average volume in the group in which purulence was identified was 4.4 cm3. Conclusion CT can identify patients with retropharyngeal infections who have a high likelihood of being successfully treated with antibiotics alone. Significance CT imaging may assist in avoiding unnecessary surgical exploration.
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Affiliation(s)
- Sarah E Shefelbine
- Department of Otolaryngology, University of Florida, Gainesville, FL 32610-0264, USA
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López F, Santamarta E, Martínez P, Sáiz-Ayala A, Llorente JL. Cavernous sinus thrombosis during pregnancy. Auris Nasus Larynx 2016; 44:232-236. [PMID: 27146007 DOI: 10.1016/j.anl.2016.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 03/24/2016] [Accepted: 04/01/2016] [Indexed: 11/27/2022]
Abstract
Cavernous sinus thrombosis (CST) represents a rare but devastating disease process that may be associated with significant long-term patient morbidity or mortality. Rapid diagnosis and aggressive medical and surgical management are imperative for patients with CST. We present the case of a 24-year-old pregnant woman with intraorbital abscess and CST secondary to Streptococcus milleri. Surgical intervention included orbital abscess drainage and dental extraction, medical therapy included intravenous antibiotic, heparin, and methylprednisolone and an elective cesarean section was performed. The latter was the key point to resolution the disease.
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Affiliation(s)
- Fernando López
- Department of Otorhinolaryngology and Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
| | - Elena Santamarta
- Department of Radiology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Patricia Martínez
- Department of Otorhinolaryngology and Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Antonio Sáiz-Ayala
- Department of Radiology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - José L Llorente
- Department of Otorhinolaryngology and Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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Zhang C, Xie B, Shi FD, Hao J. Neurological picture. Multiple intracranial arteritis and hypothyroidism secondary to Streptococcus anginosus infection. J Neurol Neurosurg Psychiatry 2015; 86:1044-5. [PMID: 25143631 PMCID: PMC4552935 DOI: 10.1136/jnnp-2014-308048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 07/27/2014] [Indexed: 11/03/2022]
Affiliation(s)
- Chao Zhang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Bingdi Xie
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Fu-Dong Shi
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Junwei Hao
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
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Verma R, Junewar V, Singh RK, Ram H, Pal US. Bilateral cavernous sinus thrombosis and facial palsy as complications of dental abscess. Natl J Maxillofac Surg 2014; 4:252-5. [PMID: 24665189 PMCID: PMC3961908 DOI: 10.4103/0975-5950.127664] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Septic cavernous sinus thrombosis (CST) related to dental infection is a rare clinical event. The septic CST is a disease of high morbidity and mortality. The prompt diagnosis and timely treatment of septic CST is cornerstone of successful outcome. The dental infection should be given due attention, as to prevent CST. In this case report of immunocompetent female, we highlighted the role of dental abscess in producing bilateral CST and facial palsy. The close collaboration between dentist and neurologist and early institution of antibiotics led to complete recovery at follow-up after 3 months. The dental infection should never be neglected as it is the interface of serious intracranial complication like CST.
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Affiliation(s)
- Rajesh Verma
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Vivek Junewar
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Rakesh Kumar Singh
- Department of Oral and Maxillofacial Surgery, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Hari Ram
- Department of Oral and Maxillofacial Surgery, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Uma Shanker Pal
- Department of Oral and Maxillofacial Surgery, King George Medical University, Lucknow, Uttar Pradesh, India
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Horowitz A, Spendel D, Kraut R, Orentlicher G. Cavernous Sinus Thrombosis as a Result of a Fungal Infection: A Case Report. J Oral Maxillofac Surg 2013; 71:1899.e1-1899.e5. [DOI: 10.1016/j.joms.2013.05.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 05/21/2013] [Accepted: 05/23/2013] [Indexed: 11/27/2022]
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Mathew GC, Ranganathan LK, Gandhi S, Jacob ME, Singh I, Solanki M, Bither S. Odontogenic maxillofacial space infections at a tertiary care center in North India: a five-year retrospective study. Int J Infect Dis 2012; 16:e296-302. [PMID: 22365137 DOI: 10.1016/j.ijid.2011.12.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 12/05/2011] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE Odontogenic infections contribute to a significant proportion of maxillofacial space infections (MSI) across the world. MSI can cause several life-threatening complications despite skillful management. The objective of this study was to review the clinical characteristics, management, and outcome of odontogenic MSI treated at a tertiary care center, and to identify the factors predisposing to life-threatening complications. METHODS A retrospective chart review of all patients treated for MSI from January 2006 to December 2010 at the Christian Medical College Hospital in Ludhiana, North India, was conducted. RESULTS Out of 137 patients identified, 66.4% were men. Mean patient age was 40 years, and 24.1% of the patients were diabetic. The most common origin was pulpal (70.8%), the most common space involved was the submandibular space, and the most common teeth responsible were the lower third molars. Twenty patients (14.6%) developed complications. Diabetes, multiple space involvement, and a total leukocyte count of ≥15×10(9)/l were associated with complications. CONCLUSIONS Patients with MSI who present with multiple space involvement, a high leukocyte count, and those with diabetes are at higher risk of developing life-threatening complications and need to be closely monitored.
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Affiliation(s)
- George C Mathew
- Department of Oral and Maxillofacial Surgery, Christian Dental College, Ludhiana, Punjab, India
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Do dental infections really cause central nervous system infections? Oral Maxillofac Surg Clin North Am 2011; 23:569-78, vii. [PMID: 21982610 DOI: 10.1016/j.coms.2011.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In the post-World War I antibiotic era, the prevalence of central nervous system (CNS) infections is estimated to be 1 per 100,000 population. The literature is replete with anecdotal case reports of CNS infections of apparent dental etiology. Conversely, it is widely cited that the incidence of CNS infection of dental etiology is only in the range of 1% to 2%. We seek to answer the question if dental infections really cause CNS infections. In this article, we focus on septic cavernous sinus thrombosis and brain abscess and if it is a diagnosis of exclusion or evidence-based.
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Jones RG, Arnold B. Sudden onset proptosis secondary to cavernous sinus thrombosis from underlying mandibular dental infection. BMJ Case Rep 2009; 2009:bcr03.2009.1671. [PMID: 21789100 PMCID: PMC3029421 DOI: 10.1136/bcr.03.2009.1671] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The present report concerns a patient who presented with a 4-day history of left-sided facial pain arising from a pre-existing dental infection and progressive shortness of breath. The patient had a previous diagnosis of rheumatoid arthritis and was being treated with methotrexate. The rapid development of a right eye proptosis necessitated urgent decompression with a lateral canthotomy and cantholysis. Imaging revealed a left facial abscess, cavernous sinus thrombosis (CST), bilateral internal jugular thrombosis and multiple lung abscesses. Blood cultures yielded Streptococcus constellatus, a member of the Peptostreptococcus family. The patient was admitted to the intensive care unit (ICU) with respiratory failure and septic shock. She was treated with intravenous meropenem and clindamycin, and anticoagulated. Despite early intervention, the patient developed a middle cerebral artery infarct. Over a 3-week period she was gradually weaned from vasopressor and ventilatory support.
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Affiliation(s)
- Robin Gwynne Jones
- Otago District Health Board, Ophthalmology, Eye Department, Second Floor, 201 Great King Street, Private Bag 1921, Dunedin, Otago, 9054, New Zealand
| | - Brendan Arnold
- Otago District Health Board, Intensive Care, 5A, 201 Great King Street, Private Bag 1921, Dunedin, Otago, 9054, New Zealand
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Conservative Treatment of Retropharyngeal and Parapharyngeal Abscess in Children. J Craniofac Surg 2009; 20:1178-81. [DOI: 10.1097/scs.0b013e3181acdc45] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Agarwal AK, Sethi A, Sethi D, Mrig S, Chopra S. Role of socioeconomic factors in deep neck abscess: A prospective study of 120 patients. Br J Oral Maxillofac Surg 2007; 45:553-5. [PMID: 17306911 DOI: 10.1016/j.bjoms.2007.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the socioeconomic factors, presentation, aetiological factors, microbiology, and management of deep neck abscesses. DESIGN Prospective study. SETTING Tertiary health care centre. PATIENTS AND METHODS We studied 120 patients with deep neck abscess who were managed in the department of otolaryngology between May 2004 and December 2005. RESULTS There were 54 male patients (45%) and 66 female (55%) with ages ranging from 18 months to 60 years. Most of the patients were of low socioeconomic status and 84 (70%) were illiterate. None were aware of the predisposing factors and potential complications of deep neck abscess. Ninety-six (80%) had poor orodental hygiene with dental infections and extraction as the most common predisposing factor followed by recurrent oropharyngeal infections. The median duration of delay before the patient presented to us was 1 week, and only 6 (5%) were aware of the primary health services available in their locality. The most common site was the submandibular region. Pain, fever, and dysphagia were the most common presenting symptoms, and Staphylococcus aureus was the most common micro-organism. All patients were treated by incision and drainage, and 10 required emergency tracheostomy. All patients responded with no complications. CONCLUSION Socioeconomic factors, particularly ignorance, illiteracy, and poverty, are important contributory factors towards the high incidence of deep neck abscess in developing countries.
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Affiliation(s)
- A K Agarwal
- Department of ENT & Head and Neck Surgery, Maulana Azad Medical College and associated L.N. Hospital, New Delhi 110002, India
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Wang J, Ahani A, Pogrel MA. A five-year retrospective study of odontogenic maxillofacial infections in a large urban public hospital. Int J Oral Maxillofac Surg 2005; 34:646-9. [PMID: 15955663 DOI: 10.1016/j.ijom.2005.03.001] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2003] [Accepted: 03/03/2005] [Indexed: 11/19/2022]
Abstract
The aim of this study was to analyze the etiology, presentation, management and outcome of odontogenic maxillofacial infections seen in an urban population that has only one major public hospital, which is also the only level I trauma center. All patients admitted to the Oral and Maxillofacial Surgery Service of San Francisco General Hospital with odontogenic infections over a 5-year period were included. Age, gender, site of infection, investigations performed, treatment carried out and outcomes were studied. Length of hospital stay and any readmissions were also noted. A total of 250 patients were admitted with maxillofacial infections, and in 157 cases the infection was odontogenic in origin. Males outnumbered females (102:55). Children had a preponderance of maxillary buccal infections whilst adults had more mandibular infections. Hospital stays ranged from 1 to 23 days, and only one patient required re-admission. A wide range of antibiotics were prescribed and 122 patients required dental extractions. Odontogenic maxillofacial infections are a public and personal health issue with potential life-threatening complications. This study identifies potential risk factors and suggests that early dental extraction, incision and drainage, coupled with intravenous antibiotic therapy, is the most effective treatment. Antibiotic therapy can be empirical since in no case where cultures were performed did this alter the antibiotic management.
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Affiliation(s)
- J Wang
- Department of Oral and Maxillofacial Surgery, University of California, San Francisco, 521 Parnassus Avenue, Box 0440, San Francisco, CA 94143-0440, USA
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