Management of Severe Odontogenic Infection: Case Report

Abstract

Introduction: Submandibular abscess caused by odontogenic infection is a frequent case, but in some cases it can be deadly because it spreads and blocks the respiratory tract. The purpose of this study is to described a case of fatal submandibular abscess with early management effective.

Case report: A 46 years old male patient with complaints of left submandibular, submental, left buccal and left temporal swelling. History of systemic disease was denied. Patients complain of tightness and changes in voice. Therapeutic intervention consists of Covid- 19 screening, complete blood lab, abscess decompression under local anesthesia, left submandibular and submental through and through drainage incisions, drainage incisions in the buccal area as well as multiple tooth extractions and penrose drain applications both extra oral and intra oral carried out in general narcotics, and swab culture sensitivity and antibacterial resistance tests were carried out. The antibiotics given were ceftriaxone and metronidazole. The patient was followed up and showed good general condition and decreased swelling.

Conclusion: Odontogenic infections that spread and block the respiratory tract can be deadly. The abscess can expand even more quickly during preparation for surgery. Decompression of an abscess can be an effective treatment so that the abscess does not spread further and can reduce the risks of the operation being carried out. The management carried out must be complete and comprehensive, in this case a drainage incision and extraction of the focal infection are carried out. Initially, broad spectrum antibiotics can be given, but if the results of the antibacterial resistance test are obtained, it is very important to give more specific antibiotics. Submandibular abscess with poor prognostic consequences obstructed respiratory tract must be treated immediately and closely monitored.

Keywords: Abscess, Odontogenic infection, Decompression