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牙源性感染引发的颅内感染:2例报告

Intracranial Infections Arising From an Odontogenic Infection: A Report of 2 Cases.

作者信息

Attouchi Ikram, Dammak Nouha, Zouaghi Hela, Ben Khelifa Mohamed

机构信息

Department of Oral Medicine and Oral Surgery, Sahloul Hospital, Sousse, Tunisia.

Department of Oral Medicine and Oral Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia.

出版信息

Clin Med Insights Case Rep. 2024 Jun 17;17:11795476241261883. doi: 10.1177/11795476241261883. eCollection 2024.

Abstract

INTRODUCTION

Intracranial empyema is a rare but serious and life-threatening infection. It is an accumulation of purulent material in the subdural or extradural space leading to development of subdural empyema or intracranial epidural abscess, respectively. The incidence of morbidity and mortality is high because the diagnosis is often unsuspected. Infections of dental origin could be responsible for such condition.

CASE REPORTS

A 22-year-old female and 30-year-old male patients, both with no significant medical history, presented with subdural empyema and intracranial epidural abscess, respectively, both complicating pan-sinusitis of dental origin. Successful outcomes were achieved with surgical drainage of the lesions, antibiotic therapy, and extraction of affected teeth. Female patient underwent further management for neurological sequelae, while male patient was discharged without neurological complications.

DISCUSSION

Intracranial suppuration of odontogenic origin is an uncommon but extremely serious complication. The most common dental origins are caries with periapical involvement and periodontitis. Wisdom tooth extraction is the most common preceding dental procedure for this infection. A multidisciplinary approach is essential for the identification and treatment of suspected oral sources. Antibiotic therapy with surgical approach is the gold standard treatment.

CONCLUSION

This sequel to odontogenic infection is quite rare, but it can be prevented by a good oral hygiene and removal of abscessed teeth.

摘要

引言

颅内积脓是一种罕见但严重且危及生命的感染。它是硬膜下或硬膜外间隙脓性物质的积聚,分别导致硬膜下积脓或颅内硬膜外脓肿的形成。由于诊断往往未被怀疑,其发病率和死亡率很高。牙源性感染可能是导致这种情况的原因。

病例报告

一名22岁女性和一名30岁男性患者,均无重大病史,分别出现硬膜下积脓和颅内硬膜外脓肿,二者均并发牙源性全鼻窦炎。通过病变的手术引流、抗生素治疗以及拔除患牙,取得了成功的治疗结果。女性患者因神经后遗症接受了进一步治疗,而男性患者出院时无神经并发症。

讨论

牙源性颅内化脓是一种罕见但极其严重的并发症。最常见的牙源性病因是伴有根尖周受累的龋齿和牙周炎。智齿拔除是这种感染最常见的前期牙科手术。多学科方法对于识别和治疗可疑的口腔来源至关重要。抗生素治疗结合手术方法是金标准治疗方案。

结论

这种牙源性感染的后遗症相当罕见,但通过良好的口腔卫生和拔除脓肿牙齿可以预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbd1/11184996/e0648e923c61/10.1177_11795476241261883-fig1.jpg

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