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Sepsis in the Head and Neck
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
Suppuration in the floor of the mouth can complicate a dental infection. Incision and drainage may be very unrewarding as there is extensive cellulitis with induration of the tissues (Ludwig’s angina).
General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Though much has been reported about the effectiveness of facial thermography in detecting dental disease, good-quality studies showing definite qualitative or quantitative data are lacking.84 As the bodies of the teeth are not directly adjacent to the external skin surface, being separated from the skin by the buccal cavity and cheek, localized tooth problems such as pain from a cracked tooth or a simple cavity in the tooth surface will not cause discernible thermographic findings. Thermography has been shown to be useful in detecting major or chronic dental infections, however (Figure 10.36).85 Persistent tooth root infection may create a minor (and often overlooked) warm area lateral to the infected area. A more developed dental abscess will cause localized soft-tissue swelling and warmth that is thermographically apparent. Herpes labialis (cold sores) may be detected in the prodromal and active stages as a warm area over the symptomatic site. Thermal findings return to normal on resolution of the viral attack.86
Ear, nose and throat
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Inflammation of the mucous membranes of the paranasal sinuses. More commonly acute but in a small proportion of cases which do not resolve, it becomes chronic. Usually related to an URTI (viral or bacterial) but in some cases will follow dental infection.
Health status in patients hospitalised for severe odontogenic infections
Published in Acta Odontologica Scandinavica, 2021
Jussi Furuholm, Niina Rautaporras, Johanna Uittamo, Mikko Saloniemi, Johanna Snäll
To hinder local or systemic spread of a dental infection, it seems to be of paramount importance to take sufficient control of the infection as early as possible. Early decisive surgical intervention leads to the shortest possible hospital stay [23]; a longer hospital stay seems to be positively related to the number of infected spaces [8,24,25]. Additionally, some patients seem to be at higher risk of requiring hospital care or even care in an intensive care unit (ICU), and a recent study reported several different prognostic factors [22,26,27]. Patients with severe OIs suffering from cardiovascular disease or who abuse drugs or alcohol are more prone to infectious complications [1,9,22]. Previous studies have shown diabetes and mental disorders to elevate this risk [1,28]. Although several studies support the association between diabetes and OIs [29,30], converse associations have also been identified [31]. Failure to recognise a worsening infection at an early state may explain the connection between these diseases and the most severe OIs. This possible connection remains ambiguous. In addition, the potential risk for previously healthy patients of developing a severe OI is less known.
Acute rhinosinusitis – are we forgetting the possibility of a dental origin? A retrospective study of 385 patients
Published in Acta Oto-Laryngologica, 2019
Annina Wuokko-Landén, Karin Blomgren, Hannamari Välimaa
After a sterile dental pulp is infected, the root canal system is colonized with a mixture of bacteria, mostly anaerobes, and when these bacteria spread into the periapical region and further into the jaw, dentoalveolar abscesses may develop [15]. Our most common findings among anaerobes and aerobes of suspected oral origin were gram-negative rods and Viridans group streptococci, respectively. The very same bacteria, here found in maxillary sinus samples, are also the most common findings in dentoalveolar abscesses [15]. Previously, anaerobic gram-negative rods and aerobic gram-positive cocci have also been linked to both acute and chronic OS [9]. We also found an association (p < .001) of the anaerobic gram-negative rods with the S. anginosus group. Therefore, when these species coexist, a dental infection should be strongly suspected.
Determination and identification of antibiotic-resistant oral streptococci isolated from active dental infections in adults
Published in Acta Odontologica Scandinavica, 2018
Juan Pablo Loyola-Rodriguez, Maria Elena Ponce-Diaz, Alejandra Loyola-Leyva, Jose O. Garcia-Cortes, Carlo E. Medina-Solis, Azael A. Contreras-Ramire, Eduardo Serena-Gomez
Another antibiotic used in oral infections is clavulanic acid (CA), which is a broad-spectrum sz-lactamase inhibitor produced from Streptomyces clavuligerus, with bactericidal activity against both Gram-positive and Gram-negative bacteria. Although CA itself has minimal antibacterial in vitro activity, when combined with beta-lactam antibiotics (amoxicillin) enhances its activity against none-sz-lactamase producing microorganisms. Besides, it has a promising activity against pathogens that cause bone infections [33]. However, some clinicians prefer the combination of A-CA due to the low level of bacterial resistance to this combination, broad-spectrum action, pharmacokinetic profile and tolerance [11]. It has been reported that A-CA had a small frequency of ARB compared with A-CA in active dental infections in primary and permanent dentitions [6,32]. These findings are in agreement with our results and reports from different countries, which suggest that A-CA is an excellent antibiotic alternative for refractory dental infections, especially in acute endodontic abscesses/cellulitis [33–35]. It has been reported that A-AC had a bactericidal activity of 98.8% and the presence of 20% of ARB (these studies were focused on anaerobic bacteria) [20,36]. In this study, A-CA was assessed against oral streptococci for bactericidal activity and ARB, and it showed a bactericidal effect of >99% and a small frequency of ARB (2.8%).