Sato Hikaru, Tamanoi Takashi, Suzuki Takuya, Moriyama Hikaru, Abe Shota, Yoshida Kenji, Kawaai Hiroyoshi, Yamazaki Shinya
Department of Dental Anesthesiology, Ohu University, School of Dentistry, Koriyama City, Fukushima Prefecture, Japan.
Ther Clin Risk Manag. 2021 Apr 22;17:365-369. doi: 10.2147/TCRM.S286764. eCollection 2021.
In general dental conditions such as dental caries and periodontal disease, a combination of adverse conditions can cause potentially life-threatening periodontal abscess. We treated a patient in whom an oral infection developed into septic shock, resulting in patient death. A 78-year-old woman experienced spontaneous pain around a moving tooth. Pus discharge was observed, the area was sterilized, and an analgesic was prescribed. A few days later, the swelling spread to the buccal region leading to difficulty while eating. Upon systemic status and blood examination at our dental hospital, depressed consciousness due to dehydration and septic shock were suspected. Oxygenation and infusion of acetate linger with antibiotics were immediately performed. Furthermore, a blood examination revealed malnutrition and a severe infection; therefore, the patient was transferred to a nearby general hospital. However, the patient died the next day because of advanced disseminated intravascular coagulation and multiple organ failure. When an oral infection is suspected in an elderly patient, antibiotics should be quickly administered, the patient's local and systemic state should be confirmed, and sterilization should be performed daily. If no improvement is observed, medical attention should be quickly sought.
在诸如龋齿和牙周病等一般牙科病症中,多种不利状况的组合可能导致有潜在生命危险的牙周脓肿。我们治疗了一名患者,其口腔感染发展为感染性休克,最终导致患者死亡。一名78岁女性在一颗活动牙齿周围出现自发疼痛。观察到有脓液排出,对该区域进行了消毒,并开了止痛药。几天后,肿胀蔓延至颊部区域,导致进食困难。在我们牙科医院进行全身状况检查和血液检查时,怀疑患者因脱水和感染性休克而意识不清。立即进行了给氧、输注醋酸盐并使用抗生素。此外,血液检查显示患者营养不良且感染严重;因此,患者被转至附近的综合医院。然而,患者次日因晚期弥散性血管内凝血和多器官功能衰竭而死亡。当怀疑老年患者有口腔感染时,应迅速给予抗生素,确认患者的局部和全身状况,并每天进行消毒。如果未见好转,应迅速寻求医疗救治。