1. Pediatric Sepsis Secondary to an Occult Dental Abscess: A Case Report.
- Author
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Holmberg P, Hellmich T, and Homme J
- Subjects
- Abscess drug therapy, Abscess surgery, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Child, Chills etiology, Emergency Service, Hospital organization & administration, Fever etiology, Humans, Lactobacillus pathogenicity, Male, Pulpectomy methods, Systemic Inflammatory Response Syndrome etiology, Systemic Inflammatory Response Syndrome surgery, Veillonella pathogenicity, Abscess complications, Dental Caries complications, Dental Caries surgery, Sepsis etiology
- Abstract
Background: In general, hematogenous spread of bacteria in children is uncommon. Bacteremia, however, is a known complication of dental procedures and severe caries, but is infrequently associated with primary, asymptomatic, non-procedural-related, dentoalveolar infection., Case Report: The patient is a 7-year-old previously healthy boy who presented to the Emergency Department (ED) with "fever, mottling, and shaking chills." In the ED, he appeared systemically ill with fever, mottling, delayed capillary refill, and rigors. Physical examination by three different physicians failed to reveal any focus of infection. Laboratory evaluation, including blood cultures, was obtained. The patient later developed unilateral facial swelling and pain, and a dentoalveolar abscess was found. He was started on antibiotics, underwent pulpectomy and eventually, extraction, prior to improvement in symptoms. Blood cultures grew two separate anaerobic bacteria (Veillonella and Lactobacillus). This is, to our knowledge, one of the first reported cases of pediatric sepsis with two different anaerobic organisms secondary to occult dentoalveolar abscess in a pediatric patient. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: It is imperative for emergency physicians to recognize the possibility of pediatric sepsis in the setting of acute maxillary or mandibular pain, as well as in patients for whom no clear focus of infection can be found. This is particularly important for those who appear ill at presentation or meet systemic inflammatory response syndrome criteria and would benefit from further laboratory evaluation, including blood cultures, and possibly antibiotic therapy., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2017
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