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Diagnosis and treatment for oral and maxillofacial multiple space infections wit

2013-07-26 15:18:59 Source: Author:JIN Jia-min1,CAI Xie-yi1,ZHANG Wei-jie1,JIANG Bin1,GUAN Xin2,LIANG Xi2,LIANG Xiang2 Hits:0
[Abstract] PURPOSE: To analyze the clinical characteristics, diagnosis and treatment of oral and maxillofacial multiple space infection with purulent pericarditis.  METHODS: A total of four patients from 2005 to 2010 were included in the study. Clinical data including etiology, episode of the disease, radiology, bacteriology, treatments and outcomes were retrospectively analyzed. RESULTS: These four cases were all males, aged between 27-52 years old. They all resulted from odontogenic infection. The interval between the diagnosis of oral and maxillofacial multiple space infection and descending necrotizing mediastinitis (DNM) was  0 to 12 days (mean 6 days),0 to 7 days from diagnosis of DNM to purulent pericarditis(mean 2.5 days).The hospitalization time ranged from 9 to 63 days(mean 42.5 days). Four different pathogens were identified by pus and blood culture from three patients. Surgical drainage, tracheotomy and intravenous antibiotics were conducted. Three were cured while one died. CONCLUSION: With the characteristics of occult process and high mortality rate, diagnosis of DNM and purulent pericarditis should be taken into consideration when there is a complaint of chest pain or dyspnea in patients with oral and maxillofacial multiple space infection. Early detection and adequate drainage is the key to success. Bacterial culture plays a guiding role for antibiotic therapy.  Supported by Research Fund of Bureau of Health of Shanghai Municipality (2007008,2012Y046).
[Key words]   Purulent pericarditis; Mediastinitis; Oral and maxillofacial multiple space infection

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