Quinn P, Guernsey L H
Oral Surg Oral Med Oral Pathol. 1985 Apr;59(4):336-9. doi: 10.1016/0030-4220(85)90053-2.
Although most odontogenic infections spread locally to adjacent fascial spaces, usually contiguous with the offending odontogenic pathosis, occasionally such an infection can spread rapidly across the midline and appear on the opposite side of the face and neck. Debilitated chronic alcohol abusers who are nutritionally deficient are more likely to develop serious life-threatening infections, either through serious airway involvement as seen in Ludwig's angina or manifest as a gram-negative septicemia with life-threatening shock and even cardiac arrest, than the usual dental patient with cellulitis. Early recognition through a high index of suspicion and vigorous monitoring will pick up the initial manifestation of toxic shock, as noted in this case report.
尽管大多数牙源性感染会局部扩散至相邻的筋膜间隙,通常与引发病变的牙源性疾病相邻,但偶尔这种感染会迅速越过中线,出现在面部和颈部的另一侧。与普通患有蜂窝织炎的牙科患者相比,营养缺乏的慢性酒精滥用者更易发生严重的、危及生命的感染,要么如路德维希咽峡炎那样严重累及气道,要么表现为革兰氏阴性败血症,伴有危及生命的休克甚至心脏骤停。通过高度的怀疑指数和积极的监测进行早期识别,将会发现中毒性休克的初始表现,如本病例报告中所述。