BACKGROUND Odontogenic infection is one of the common infectious diseases in oral and maxillofacial head and neck regions.Clinically,if early odontogenic infections such as acute periapical periodontitis,alveolar absc...BACKGROUND Odontogenic infection is one of the common infectious diseases in oral and maxillofacial head and neck regions.Clinically,if early odontogenic infections such as acute periapical periodontitis,alveolar abscess,and pericoronitis of wisdom teeth are not treated timely,effectively and correctly,the infected tissue may spread up to the skull and brain,down to the thoracic cavity,abdominal cavity and other areas through the natural potential fascial space in the oral and maxillofacial head and neck.Severe multi-space infections are formed and can eventually lead to life-threatening complications(LTCs),such as intracranial infection,pleural effusion,empyema,sepsis and even death.CASE SUMMARY We report a rare case of death in a 41-year-old man with severe odontogenic multi-space infections in the oral and maxillofacial head and neck regions.One week before admission,due to pain in the right lower posterior teeth,the patient placed a cigarette butt dipped in the pesticide"Miehailin"into the"dental cavity"to relieve the pain.Within a week,the infection gradually spread bilaterally to the floor of the mouth,submandibular space,neck,chest,waist,back,temporal and other areas.The patient had difficulty breathing,swallowing and eating,and was transferred to our hospital as an emergency admission.Following admission,oral and maxillofacial surgeons immediately organized consultations with doctors in otolaryngology,thoracic surgery,general surgery,hematology,anesthesia and the intensive care unit to assist with treatment.The patient was treated with the highest level of antibiotics(vancomycin)and extensive abscess incision and drainage in the oral,maxillofacial,head and neck,chest and back regions.Unfortunately,the patient died of septic shock and multiple organ failure on the third day after admission.CONCLUSION Odontogenic infection can cause serious multi-space infections in the oral and maxillofacial head and neck regions,which can result in multiple LTCs.The management and treatment of LTCs such as multi-space infections should be multidisciplinary led by oral and maxillofacial surgeons.展开更多
重症口腔颌面颈部多间隙感染患者占总住院患者的3.95%(115/2 910),其中男女比1.88∶1,平均年龄53岁(6~83岁),牙源性感染占80%,农村人群占79.13%。从发病到就诊时间平均为9.5 d(3~30 d),仅33.91%就诊于1周内。入院前3.48%的患者未接受过...重症口腔颌面颈部多间隙感染患者占总住院患者的3.95%(115/2 910),其中男女比1.88∶1,平均年龄53岁(6~83岁),牙源性感染占80%,农村人群占79.13%。从发病到就诊时间平均为9.5 d(3~30 d),仅33.91%就诊于1周内。入院前3.48%的患者未接受过任何治疗,19.13%自服消炎药,县、乡两级医院仅对9例患者开髓、6例患者脓肿切排。入院后80例患者采用一次性多功能引流管辅助冲洗技术治疗,32例采用传统治疗。多功能引流管治疗组治愈率(90%vs 75%,P=0.03),住院天数(15.01±0.53 vs 18.13±0.85,P=0.02),抗菌药物使用天数(11.89±0.43 vs 16.25±0.84,P<0.00),医生换药频次(5.71±0.28 vs 23.75±1.63,P<0.00)等均优于传统组。展开更多
目的:分析口腔颌面部间隙感染(oral and maxillofacial space infection,OMSI)合并糖尿病、应激性高血糖及血糖正常患者之间一般资料、临床表现、实验室检查及感染的优势菌群之间的差异。方法:收集2020年8月—2022年6月就诊于上海交通...目的:分析口腔颌面部间隙感染(oral and maxillofacial space infection,OMSI)合并糖尿病、应激性高血糖及血糖正常患者之间一般资料、临床表现、实验室检查及感染的优势菌群之间的差异。方法:收集2020年8月—2022年6月就诊于上海交通大学医学院附属第九人民医院口腔外科的190例OMSI患者进行回顾性分析。根据血糖的差异分成糖尿病组、应激性高血糖组及正常组。比较3组患者的流行病学、临床资料及实验室相关检查的差异。采用SPSS 25.0软件包对数据进行统计学分析。结果:糖尿病组与应激性高血糖组之间淋巴细胞绝对数、钠、氯之间具有显著差异;糖尿病组与血糖正常组之间年龄、中性粒细胞绝对数、中性粒细胞百分数、淋巴细胞百分数、C反应蛋白、IL-6、IL-8、肿瘤坏死因子α、降钙素原、尿素、血清尿酸、纤维蛋白原、钠、氯、总二氧化碳之间具有显著差异;应激性高血糖组与血糖正常组之间中性粒细胞百分数、淋巴细胞百分数、淋巴细胞绝对数、C反应蛋白、IL-8、肿瘤坏死因子α、尿素之间具有显著差异(P<0.05)。结论:OMSI合并糖尿病、应激性高血糖、血糖正常患者的临床特征和实验室检查结果具有差异,提示临床诊疗时应当区分这3组患者,提供更具针对性的治疗措施。展开更多
文摘BACKGROUND Odontogenic infection is one of the common infectious diseases in oral and maxillofacial head and neck regions.Clinically,if early odontogenic infections such as acute periapical periodontitis,alveolar abscess,and pericoronitis of wisdom teeth are not treated timely,effectively and correctly,the infected tissue may spread up to the skull and brain,down to the thoracic cavity,abdominal cavity and other areas through the natural potential fascial space in the oral and maxillofacial head and neck.Severe multi-space infections are formed and can eventually lead to life-threatening complications(LTCs),such as intracranial infection,pleural effusion,empyema,sepsis and even death.CASE SUMMARY We report a rare case of death in a 41-year-old man with severe odontogenic multi-space infections in the oral and maxillofacial head and neck regions.One week before admission,due to pain in the right lower posterior teeth,the patient placed a cigarette butt dipped in the pesticide"Miehailin"into the"dental cavity"to relieve the pain.Within a week,the infection gradually spread bilaterally to the floor of the mouth,submandibular space,neck,chest,waist,back,temporal and other areas.The patient had difficulty breathing,swallowing and eating,and was transferred to our hospital as an emergency admission.Following admission,oral and maxillofacial surgeons immediately organized consultations with doctors in otolaryngology,thoracic surgery,general surgery,hematology,anesthesia and the intensive care unit to assist with treatment.The patient was treated with the highest level of antibiotics(vancomycin)and extensive abscess incision and drainage in the oral,maxillofacial,head and neck,chest and back regions.Unfortunately,the patient died of septic shock and multiple organ failure on the third day after admission.CONCLUSION Odontogenic infection can cause serious multi-space infections in the oral and maxillofacial head and neck regions,which can result in multiple LTCs.The management and treatment of LTCs such as multi-space infections should be multidisciplinary led by oral and maxillofacial surgeons.
文摘重症口腔颌面颈部多间隙感染患者占总住院患者的3.95%(115/2 910),其中男女比1.88∶1,平均年龄53岁(6~83岁),牙源性感染占80%,农村人群占79.13%。从发病到就诊时间平均为9.5 d(3~30 d),仅33.91%就诊于1周内。入院前3.48%的患者未接受过任何治疗,19.13%自服消炎药,县、乡两级医院仅对9例患者开髓、6例患者脓肿切排。入院后80例患者采用一次性多功能引流管辅助冲洗技术治疗,32例采用传统治疗。多功能引流管治疗组治愈率(90%vs 75%,P=0.03),住院天数(15.01±0.53 vs 18.13±0.85,P=0.02),抗菌药物使用天数(11.89±0.43 vs 16.25±0.84,P<0.00),医生换药频次(5.71±0.28 vs 23.75±1.63,P<0.00)等均优于传统组。
文摘目的:分析口腔颌面部间隙感染(oral and maxillofacial space infection,OMSI)合并糖尿病、应激性高血糖及血糖正常患者之间一般资料、临床表现、实验室检查及感染的优势菌群之间的差异。方法:收集2020年8月—2022年6月就诊于上海交通大学医学院附属第九人民医院口腔外科的190例OMSI患者进行回顾性分析。根据血糖的差异分成糖尿病组、应激性高血糖组及正常组。比较3组患者的流行病学、临床资料及实验室相关检查的差异。采用SPSS 25.0软件包对数据进行统计学分析。结果:糖尿病组与应激性高血糖组之间淋巴细胞绝对数、钠、氯之间具有显著差异;糖尿病组与血糖正常组之间年龄、中性粒细胞绝对数、中性粒细胞百分数、淋巴细胞百分数、C反应蛋白、IL-6、IL-8、肿瘤坏死因子α、降钙素原、尿素、血清尿酸、纤维蛋白原、钠、氯、总二氧化碳之间具有显著差异;应激性高血糖组与血糖正常组之间中性粒细胞百分数、淋巴细胞百分数、淋巴细胞绝对数、C反应蛋白、IL-8、肿瘤坏死因子α、尿素之间具有显著差异(P<0.05)。结论:OMSI合并糖尿病、应激性高血糖、血糖正常患者的临床特征和实验室检查结果具有差异,提示临床诊疗时应当区分这3组患者,提供更具针对性的治疗措施。
