Deep neck abscesses of odontogenic origin and multiple organ failure. A case
report and review of the literature
Konstantina MENDRINOU, Dimitrios ANTERRIOTIS, Eudokia KATSANOU, Athina KOUTSIOULI, George DOUNIS, Kalliopi PAPAKONSTANTINOU
Department of Oral and Maxillofacial Surgery (Head: I. Dimopoulos), Intensive Care Unit (Head: Dr K. Papakonstantinou), General Hospital “G. Gennimatas”, Athens, Greece
Hellenic Archives of Oral & Maxillofacial Surgery (2014) 3, 121-132
SUMMARY: During the last decade, the incidence of inhospital admissions due to severe odontogenic infections with consequent potentially fatal complications necessitating ICU hospitalization has been increasing worldwide. The aforementioned infections are polymicrobial, caused by various facultative anaerobes and strict anaerobes. Hereby, the case of a 57 years old patient, who has been admitted in the Intensive Care Unit (ICU) due to coma of undefined origin, with subsequent multiple organ failure on the ground of septic shock, is presented. The latter has been eventually attributed to the development of deep neck abscesses of odontogenic origin; hence it has been successfully treated with antibiotics, surgical drainage and pertinent supportive measures.
KEY WORDS: Deep neck abscesses, complicated odontogenic infections, spread of dental abscess, multiple organ failure of odontogenic origin.
REFERENCES
ACCP/SCCM Consensus Conference Committee: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med. 20:864-874, 1992
Boffano P, Roccia F, Pittoni D, Di Dio D, Forni P, Gallesio C.: Management of 112 hospitalized patients with spreading odontogenic infections: correlation with DMFT and Oral Health Impact Profile 14 indexes. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 113(2):207-13, 2012
Bridgeman A, Wiesenfeld D, Hellyar A, Sheldon W.: Major maxillofacial infections. An evaluation of 107 cases. Aust Dent J. 40:281-288, 1995
Bross-Soriano D, Arrieta-Gomez JR, Prado-Calleros H, SchimelmitzIdi J, Jorba-Basave S.: Management of Ludwing’s angina with small neck incisions: 18 years experience. Otolaryngol Head Neck Surg. 130:712-717, 2004
Coticchia JM, Getnick GS, Yun RD, Arnold JE.: Age, site, and time specific differences in pediatric deep neck abscesses. Arch Otolaryngol Head Neck Surg. 130:201-201, 2004
Dodson TB, Perrott DH, Kaban LB.: Pediatric maxillofacial infections: a retrospective study of 113 patients. J Oral Maxillofac Surg. 47:327-330. 1989
Fazakerley M, Mc Gowan P, Hardy P, Martin M.: A comparative study of cephradine, amoxycollin and phenoxymethyl-penicillin in the treatment of acute dentoalveolar infection. Br Dent J 174:359- 363, 1993
Fehrenbach M, Herring S.: Spread of dental infection. Practical Hygiene. 13-18, September/October 1997
Flynn T, Shanti R, Hayes C.: Severe odontogenic infections, part 2: prospective outcomes study. J Oral Maxillofac Surg. 64:1104-1113, 2006
Gilmore W Jacobus N, Gorbach S, Doku H, Tally F.: A prospective double-blind evaluation of penicillin versus clindamycin in the treatment of odontogenic infections. J Oral Maxillofac Surg. 46:1065-1070, 1988
Gorbach S, Gilmore W, Jacobus N, Doku H, Tally F.: Microbiology and antibiotic resistance in odontogenic infections. Ann Otol Rhinol Laryngol Supl. 154:40-42, 1991
Goumas P, Naxakis S, Papavasiliou D, Moschovakis E, Tsintsos S, Skoutelis A.: Periapical abscesses: causal bacteria and antibiotic sensitivity. J Chemother. 9:415-419, 1997
Han J, Kerschner J.: Streptococcus milleri: an organism for head and neck infections and abscess. Arch Otolaryngol Head Neck Surg. 127:650-654, 2001 Handley T, Devlin M, Kappel D, Mc Caul J.: The sepsis syndrome in odontogenic infection JICS. 10:21-25, 2009
Haug RH, Hoffman MJ, Indresano AT.: An epidemiologic and anatomic survey of odontogenic infections. J Oral Maxillofac Surg. 49:976, 1991 Information and Statistics Division. NHS National Services Scotland. Reference ISD/HIG/IR2005- 01474. Edinburgh, UK. 2007
Khemaleelakul S, Baumgartner J, Pruksakom S.: Identification of bacteria in acute endodontic infections and their antimicrobial susceptibility. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 94:746- 755, 2002
Kinzer S, Pfeiffer J, Becker S, Ridder GJ.: Severe deep neck space infections and mediastinitis of odontogenic origin: clinical relevance and implications for diagnois and treatment. Acta Oto-Laryngol. 129:62-70, 2009
Kuriyama T, Karasawa T, Nakagawa K, Saiki Y, Yamamoto E and Nakamura S.: Bacteriologic features and antimicrobial susceptibility in isolates from orofacial odontogenic infactions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:600-608, 2000
Levy M. et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Intens Care Med. 29: 530-538, 2003
Lewis M, Carmichael F, Mac- Farlane T, Milligan S.: A randomized trial of co-amoxiclav (Augmentin) versus penicillin V in the treatment of acute dentoalveolar abscess. Br Dent J. 175:169-174, 1993
Malliari H, Tsakiropoulou E, Nikolaidis V, Printza A et al.: Maxillofacial and deep neck infections of an odontogenic origin. Otorhinolaryngologia- Head and Neck Surgery Issue. 46:29-32, 2011
Medscape: Management and Prevention of Odontogenic Infections, Clinical review, April 2003 Mangundjala S, Hardjawinata K.: Clindamycin versus ampicillin in the treatment of odontogenic infections. Clin Ther. 12:242-249, 1990
Mihos P, Potaris K, Gakidis I, Papadakis D, Rallis G.: Management of descending necrotizing mediastinitis. J Oral Maxillofac Surg. 62:966-972, 2004
Miller WD, Furst IM, Sandor GK et al.: A prospective, blinded comparison of clinical examination and computed tomography in deep neck infections. Laryngoscope. 109(11):1873-9, Nov 1999
Newlands S. et al: Head and Neck Surgery- Otolaryngology, 4th Edition, Vol 1:Chapter 47,665-681.
Lippincott Williams and Wilkins, Philadelphia- USA, 2006 Papalia E, Rena O, Oliaro A et al.: Descending necrotizing mediastinitis: surgical management. Eur J Cardiothorac Surg. 20:739-742, 2001
Παπασπύρου Σ.: Εν τω βάθει τραχηλοπροσωπικές φλεγμονές. Τεχνόγραμμα, Αθήνα, 1993
Peters E, Fong B, Wormuth D, Sonis S.: Risk factors affecting hospital length of stay in patients with odontogenic maxillofacial infections. J Oral Maxillofac Surg. 54:1386-1391, 1996
Plaza Mayor G, Martinez-San Millian J, Martinez Vidal A.: Is conservative treatment of deep neck space infections appropriate? Head Neck. 23(2):126-33, Feb 2001
Reader C, Boniface M, Bulanda-Wagner S.: Refractory endodontic lesion associated with Staphylococci aureus. J Endod. 20:607-609, 1994 Robertson D, Smith A.: The microbiology of the acute dental abscess. Journal of Medical Microbiology. 58:155-162, 2009
Roche Y, Yoshimori R.: In vitro activity of spiramycin and metronidazole alone or in combination against clinical isolates from odontogenic abscesses. J Antimicrob Chemother. 40:353-357, 1997
Sanchez R, Mirada E, Arias J, Pano JR, Burgueno M.: Severe odontogenic infections: epidemiological, microbiological and therapeutic factors. Med Oral Patol Oral Cir Bucal. 16:e670-e676, 2011
Sancho LMM, Minamoto H, Fernandez A, Sennes LU, Jatene FB.: Descending necrotizing mediastinitis: a retrospective surgical experience. Eur J Cardiothorac Surg 16:200-205,1999
Sato FRL, Hajala FAC, Filho FWVF, de Moraes M.: Eight-year retrospective study of odontogenic origin infections in a postgraduation program on oral and maxillofacial surgery. J Oral Maxillofac Surg. 67:1092-1097, 2009
Schuman J, Turner J.: The clinical significance of beta hemolytic streptococci of the milleri group in oral abscesses. J Clin Pediatr Dent. 23:137-142, 1999 Seppanen L, Lauhio A, Lindqvist C, Surronen R, Rautemaa R.: Analysis of systemic and local odontogenic infection complications requiring hospital care. J Infec. 57:116-122, 2008
Storoe W, Haug RH, Lillich TT.: The changing face of odontogenic infections. J Oral Maxillofac Surg. 59:739-748, 2001
Tan P, Chang L, Huang Y, Chiu C, Wang C, Lin T.: Deep neck infections in children. J Microbiol Immunol Infect. 34:287-292
Thomas SJ, Atkinson C, Hughes C, Revington P, Ne AR.: Is there an epidemic of admissions for surgical treatment of dental abscesses in the UK? BMJ. 336:1219-1220, 2008
Uluibau IC, Jaunay T, Goss AN.: Severe odontogenic infections. Australian Dental Journal Medications Supplement. 50:4, s74-s81, 2005
Vassiliou A, Banagos J, Minisiou M, Papageorgiou S, Efstathidis A, Androulakis M.: Epiglottitis and deep neck space infections: a case report. ORL. 169-176, 2009
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. 34:646-649, 2005
Wong TY.: A nationwide survey of deaths from oral and maxillofacial infections: the Taiwanese experience. J Oral Maxillofac Surg. 57:1297-1299, 1999
Ylijoki S, Suuronen R, Jousimies-Somer H, Meurman J, Lindqvist C.: Differences between patients with or without the need for intensive care due to severe odontogenic infections. J Oral Maxillofac Surg. 59:867-872, 2001
Department of Oral and Maxillofacial Surgery (Head: I. Dimopoulos), Intensive Care Unit (Head: Dr K. Papakonstantinou), General Hospital “G. Gennimatas”, Athens, Greece
Hellenic Archives of Oral & Maxillofacial Surgery (2014) 3, 121-132
SUMMARY: During the last decade, the incidence of inhospital admissions due to severe odontogenic infections with consequent potentially fatal complications necessitating ICU hospitalization has been increasing worldwide. The aforementioned infections are polymicrobial, caused by various facultative anaerobes and strict anaerobes. Hereby, the case of a 57 years old patient, who has been admitted in the Intensive Care Unit (ICU) due to coma of undefined origin, with subsequent multiple organ failure on the ground of septic shock, is presented. The latter has been eventually attributed to the development of deep neck abscesses of odontogenic origin; hence it has been successfully treated with antibiotics, surgical drainage and pertinent supportive measures.
KEY WORDS: Deep neck abscesses, complicated odontogenic infections, spread of dental abscess, multiple organ failure of odontogenic origin.
REFERENCES
ACCP/SCCM Consensus Conference Committee: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med. 20:864-874, 1992
Boffano P, Roccia F, Pittoni D, Di Dio D, Forni P, Gallesio C.: Management of 112 hospitalized patients with spreading odontogenic infections: correlation with DMFT and Oral Health Impact Profile 14 indexes. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 113(2):207-13, 2012
Bridgeman A, Wiesenfeld D, Hellyar A, Sheldon W.: Major maxillofacial infections. An evaluation of 107 cases. Aust Dent J. 40:281-288, 1995
Bross-Soriano D, Arrieta-Gomez JR, Prado-Calleros H, SchimelmitzIdi J, Jorba-Basave S.: Management of Ludwing’s angina with small neck incisions: 18 years experience. Otolaryngol Head Neck Surg. 130:712-717, 2004
Coticchia JM, Getnick GS, Yun RD, Arnold JE.: Age, site, and time specific differences in pediatric deep neck abscesses. Arch Otolaryngol Head Neck Surg. 130:201-201, 2004
Dodson TB, Perrott DH, Kaban LB.: Pediatric maxillofacial infections: a retrospective study of 113 patients. J Oral Maxillofac Surg. 47:327-330. 1989
Fazakerley M, Mc Gowan P, Hardy P, Martin M.: A comparative study of cephradine, amoxycollin and phenoxymethyl-penicillin in the treatment of acute dentoalveolar infection. Br Dent J 174:359- 363, 1993
Fehrenbach M, Herring S.: Spread of dental infection. Practical Hygiene. 13-18, September/October 1997
Flynn T, Shanti R, Hayes C.: Severe odontogenic infections, part 2: prospective outcomes study. J Oral Maxillofac Surg. 64:1104-1113, 2006
Gilmore W Jacobus N, Gorbach S, Doku H, Tally F.: A prospective double-blind evaluation of penicillin versus clindamycin in the treatment of odontogenic infections. J Oral Maxillofac Surg. 46:1065-1070, 1988
Gorbach S, Gilmore W, Jacobus N, Doku H, Tally F.: Microbiology and antibiotic resistance in odontogenic infections. Ann Otol Rhinol Laryngol Supl. 154:40-42, 1991
Goumas P, Naxakis S, Papavasiliou D, Moschovakis E, Tsintsos S, Skoutelis A.: Periapical abscesses: causal bacteria and antibiotic sensitivity. J Chemother. 9:415-419, 1997
Han J, Kerschner J.: Streptococcus milleri: an organism for head and neck infections and abscess. Arch Otolaryngol Head Neck Surg. 127:650-654, 2001 Handley T, Devlin M, Kappel D, Mc Caul J.: The sepsis syndrome in odontogenic infection JICS. 10:21-25, 2009
Haug RH, Hoffman MJ, Indresano AT.: An epidemiologic and anatomic survey of odontogenic infections. J Oral Maxillofac Surg. 49:976, 1991 Information and Statistics Division. NHS National Services Scotland. Reference ISD/HIG/IR2005- 01474. Edinburgh, UK. 2007
Khemaleelakul S, Baumgartner J, Pruksakom S.: Identification of bacteria in acute endodontic infections and their antimicrobial susceptibility. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 94:746- 755, 2002
Kinzer S, Pfeiffer J, Becker S, Ridder GJ.: Severe deep neck space infections and mediastinitis of odontogenic origin: clinical relevance and implications for diagnois and treatment. Acta Oto-Laryngol. 129:62-70, 2009
Kuriyama T, Karasawa T, Nakagawa K, Saiki Y, Yamamoto E and Nakamura S.: Bacteriologic features and antimicrobial susceptibility in isolates from orofacial odontogenic infactions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:600-608, 2000
Levy M. et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Intens Care Med. 29: 530-538, 2003
Lewis M, Carmichael F, Mac- Farlane T, Milligan S.: A randomized trial of co-amoxiclav (Augmentin) versus penicillin V in the treatment of acute dentoalveolar abscess. Br Dent J. 175:169-174, 1993
Malliari H, Tsakiropoulou E, Nikolaidis V, Printza A et al.: Maxillofacial and deep neck infections of an odontogenic origin. Otorhinolaryngologia- Head and Neck Surgery Issue. 46:29-32, 2011
Medscape: Management and Prevention of Odontogenic Infections, Clinical review, April 2003 Mangundjala S, Hardjawinata K.: Clindamycin versus ampicillin in the treatment of odontogenic infections. Clin Ther. 12:242-249, 1990
Mihos P, Potaris K, Gakidis I, Papadakis D, Rallis G.: Management of descending necrotizing mediastinitis. J Oral Maxillofac Surg. 62:966-972, 2004
Miller WD, Furst IM, Sandor GK et al.: A prospective, blinded comparison of clinical examination and computed tomography in deep neck infections. Laryngoscope. 109(11):1873-9, Nov 1999
Newlands S. et al: Head and Neck Surgery- Otolaryngology, 4th Edition, Vol 1:Chapter 47,665-681.
Lippincott Williams and Wilkins, Philadelphia- USA, 2006 Papalia E, Rena O, Oliaro A et al.: Descending necrotizing mediastinitis: surgical management. Eur J Cardiothorac Surg. 20:739-742, 2001
Παπασπύρου Σ.: Εν τω βάθει τραχηλοπροσωπικές φλεγμονές. Τεχνόγραμμα, Αθήνα, 1993
Peters E, Fong B, Wormuth D, Sonis S.: Risk factors affecting hospital length of stay in patients with odontogenic maxillofacial infections. J Oral Maxillofac Surg. 54:1386-1391, 1996
Plaza Mayor G, Martinez-San Millian J, Martinez Vidal A.: Is conservative treatment of deep neck space infections appropriate? Head Neck. 23(2):126-33, Feb 2001
Reader C, Boniface M, Bulanda-Wagner S.: Refractory endodontic lesion associated with Staphylococci aureus. J Endod. 20:607-609, 1994 Robertson D, Smith A.: The microbiology of the acute dental abscess. Journal of Medical Microbiology. 58:155-162, 2009
Roche Y, Yoshimori R.: In vitro activity of spiramycin and metronidazole alone or in combination against clinical isolates from odontogenic abscesses. J Antimicrob Chemother. 40:353-357, 1997
Sanchez R, Mirada E, Arias J, Pano JR, Burgueno M.: Severe odontogenic infections: epidemiological, microbiological and therapeutic factors. Med Oral Patol Oral Cir Bucal. 16:e670-e676, 2011
Sancho LMM, Minamoto H, Fernandez A, Sennes LU, Jatene FB.: Descending necrotizing mediastinitis: a retrospective surgical experience. Eur J Cardiothorac Surg 16:200-205,1999
Sato FRL, Hajala FAC, Filho FWVF, de Moraes M.: Eight-year retrospective study of odontogenic origin infections in a postgraduation program on oral and maxillofacial surgery. J Oral Maxillofac Surg. 67:1092-1097, 2009
Schuman J, Turner J.: The clinical significance of beta hemolytic streptococci of the milleri group in oral abscesses. J Clin Pediatr Dent. 23:137-142, 1999 Seppanen L, Lauhio A, Lindqvist C, Surronen R, Rautemaa R.: Analysis of systemic and local odontogenic infection complications requiring hospital care. J Infec. 57:116-122, 2008
Storoe W, Haug RH, Lillich TT.: The changing face of odontogenic infections. J Oral Maxillofac Surg. 59:739-748, 2001
Tan P, Chang L, Huang Y, Chiu C, Wang C, Lin T.: Deep neck infections in children. J Microbiol Immunol Infect. 34:287-292
Thomas SJ, Atkinson C, Hughes C, Revington P, Ne AR.: Is there an epidemic of admissions for surgical treatment of dental abscesses in the UK? BMJ. 336:1219-1220, 2008
Uluibau IC, Jaunay T, Goss AN.: Severe odontogenic infections. Australian Dental Journal Medications Supplement. 50:4, s74-s81, 2005
Vassiliou A, Banagos J, Minisiou M, Papageorgiou S, Efstathidis A, Androulakis M.: Epiglottitis and deep neck space infections: a case report. ORL. 169-176, 2009
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. 34:646-649, 2005
Wong TY.: A nationwide survey of deaths from oral and maxillofacial infections: the Taiwanese experience. J Oral Maxillofac Surg. 57:1297-1299, 1999
Ylijoki S, Suuronen R, Jousimies-Somer H, Meurman J, Lindqvist C.: Differences between patients with or without the need for intensive care due to severe odontogenic infections. J Oral Maxillofac Surg. 59:867-872, 2001
How to cite this article:
|
View the full-text PDF:
|
| ||