ID 109785
Title Transcription
コウカセイ エシセイ ジュウカクエン オ ハッショウ シタ カガク チシ シュウイエン ノ 1レイ
Title Alternative
A Case of Pericoronitis of Lower Wisdom Tooth Leading to Descending Necrotizing Mediastinitis
Author
Momota, Yukihiro Department of Oral and Maxillofacial Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Satomura, Kazuhito Department of Oral and Maxillofacial Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School
Tokuyama, Reiko Department of Oral and Maxillofacial Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School
Yuasa, Tetsuya Department of Oral and Maxillofacial Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School
Kudo, Keiko Department of Oral and Maxillofacial Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Takano, Hideyuki Department of Oral and Maxillofacial Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Keywords
智歯周囲炎
降下性壊死性縦隔炎
多臓器不全
糖尿病
Content Type
Journal Article
Description
We present a case of pericoronitis of lower wisdom tooth leading to descending necrotizing mediastinitis. A 52-year-old man visited our hospital because of swelling and pain in buccal region on the right side in spite of chemotherapeutics at a practicing physician, whose diabetic nephropathy had been treated with dialysis treatment by the same physician. Orthopantomography elucidated an impacted wisdom tooth of the right side mandible and osteosclerosis around there. CT revealed inflammatory thickening of subcutaneous fat tissue from buccal to cervical region. In the blood examination, the values of WBCs, RBCs, platelets, CRP, AST, LDH, TG, BUN, creatinine, GLU, K and Ca increased abnormally, while those of hemoglobin, MCV,MCH,MCHC, albumin, Cl, decreased extraordinarily. Immediate medication of antibiotics was worked out under a clinical diagnosis of pericoronitis of lower wisdom tooth, periostitis of the mandible and cervical cellulitis. Nevertheless, rapid inflamation progressed downward; mediastinal abscess was found by CT image taken 6 days later from the beginning of the therapy. Immediately, extraction of pathogenic teeth, cervical drainage, and transcervical and transthoracic mediastinal drainage were performed under a diagnosis of descending necrotizing mediastinitis. Moreover, bacterial examination was performed using a pus specimen derived from abscess; α-Streptococcus and Prevotella intermedia were detected. CT taken 2 weeks later from the beginning of the therapy revealed continuing bilateral pleural and pericardial effusion in spite of intensive care. Unfortunately he was died of multi organ failure caused by septic shock a month later from the beginning of the therapy.
Journal Title
四国歯学会雑誌
ISSN
09146091
NCID
AN10050046
Publisher
四国歯学会
Volume
21
Issue
2
Start Page
413
End Page
419
Sort Key
413
Published Date
2009-01-31
EDB ID
FullText File
language
jpn
TextVersion
Publisher
departments
Oral Sciences
University Hospital