Remember the teeth! Cutaneous manifestation of odontogenic sepsis: A case study

IF 1.5 Q3 SURGERY

JPRAS Open Pub Date : 2024-11-28 DOI:10.1016/j.jpra.2024.11.013

Lilli Ladurner, Maather Al Zadjali, Manjit Dhillon

{"title":"Remember the teeth! Cutaneous manifestation of odontogenic sepsis: A case study","authors":"Lilli Ladurner, Maather Al Zadjali, Manjit Dhillon","doi":"10.1016/j.jpra.2024.11.013","DOIUrl":null,"url":null,"abstract":"<div><div>We present the case of a 21-year-old male with a 3-year history of an isolated 1 × 1 cm purulent lesion on the left cheek, on a background of mild acne. Despite topical treatments, the lump persisted, discharging frank pus regularly. Microbiology swabs and an incisional biopsy were unremarkable. A further two excisions were performed but wound healing was poor, and the lesion returned.</div><div>Upon referral to Oral and Maxillofacial Surgery, examination of the oral cavity suggested a dental abscess from the maxillary molar tooth. This was confirmed radiographically on an orthopantomogram and cone beam CT. He had been asymptomatic from his heavily filled teeth which may have silently lost vitality. The dental abscess tracked towards the cheek forming a discharging fistula. The offending teeth were extracted, and the cutaneous lesion healed spontaneously, leaving a 2 × 1.8 cm disfiguring, indented scar.</div><div>This case highlights that dental abscesses can fistulate cutaneously and that an odontogenic cause for cutaneous lesions around the mouth should be considered in the differentials.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 227-231"},"PeriodicalIF":1.5000,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732101/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JPRAS Open","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352587824001864","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

We present the case of a 21-year-old male with a 3-year history of an isolated 1 × 1 cm purulent lesion on the left cheek, on a background of mild acne. Despite topical treatments, the lump persisted, discharging frank pus regularly. Microbiology swabs and an incisional biopsy were unremarkable. A further two excisions were performed but wound healing was poor, and the lesion returned.

Upon referral to Oral and Maxillofacial Surgery, examination of the oral cavity suggested a dental abscess from the maxillary molar tooth. This was confirmed radiographically on an orthopantomogram and cone beam CT. He had been asymptomatic from his heavily filled teeth which may have silently lost vitality. The dental abscess tracked towards the cheek forming a discharging fistula. The offending teeth were extracted, and the cutaneous lesion healed spontaneously, leaving a 2 × 1.8 cm disfiguring, indented scar.

This case highlights that dental abscesses can fistulate cutaneously and that an odontogenic cause for cutaneous lesions around the mouth should be considered in the differentials.

查看原文本刊更多论文

记住牙齿！牙源性败血症的皮肤表现：一个病例研究。

我们提出的情况下，21岁的男性与3年的历史孤立的1 × 1厘米化脓性病变的左脸颊，背景轻度痤疮。尽管局部治疗，肿块仍然存在，定期排出脓液。微生物拭子和切口活检无显著差异。再做了两次手术，但伤口愈合不良，病变复发。在转介到口腔颌面外科后，口腔检查显示上颌磨牙有牙脓肿。这在正体层析成像和锥束CT上得到证实。他的牙齿可能已经无声地失去了活力，因此没有任何症状。牙脓肿向脸颊延伸，形成排出瘘管。拔除问题牙，皮肤病变自行愈合，留下2 × 1.8 cm的凹陷疤痕。本病例强调牙脓肿可在皮肤上形成瘘，在鉴别时应考虑口腔周围皮肤病变的牙源性原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

JPRAS Open Medicine-Surgery

CiteScore

1.60

自引率

0.00%

发文量

审稿时长

22 weeks

期刊介绍： JPRAS Open is an international, open access journal dedicated to publishing case reports, short communications, and full-length articles. JPRAS Open will provide the most current source of information and references in plastic, reconstructive & aesthetic surgery. The Journal is based on the continued need to improve surgical care by providing highlights in general reconstructive surgery; cleft lip, palate and craniofacial surgery; head and neck surgery; skin cancer; breast surgery; hand surgery; lower limb trauma; burns; and aesthetic surgery. The Journal will provide authors with fast publication times.