Orbital Subperiosteal Abscess Associated with Mandibular Wisdom Tooth Infection: A Case Report.

BACKGROUND: Orbital infection related to mandibular third molar infection is extremely rare. Most of cases reported in literature are related to maxillary molar teeth. Odontogenic infections are not common causes of orbital abscess but it should always be put in consideration when dealing with orbital cellulitis and abscess. CASE PRESENTATION: This is a case of orbital abscess involving the left eye as consequence of lower left third molar infection in otherwise healthy 35-year-old black male patient. CT scan confirmed the unusual pathway of this space infection from the lower third molar and excluded any intracranial involvement. The abscess was drained immediately by intraoral incisions and the tooth was extracted. There was a dramatic improvement in a very short time with normal eye movement. CONCLUSION: This case demonstrates one of the serious consequences of odontogenic infection which may lead to cavernous sinus thrombosis and blindness if not treated promptly.

A case of labio-facial necrotizing fasciitis complicating acne.

BACKGROUND: Facial necrotizing fasciitis is extremely rare. Most of the cases reported in literature are related to dental, sinus, tonsillar and salivary glands causes, but rarely as consequence of skin infection. We report a unique case of lower lip cellulitis, which was initially misdiagnosed as angioedema and subsequently progressed into lower lip necrotizing fasciitis. CASE PRESENTATION: This is a case report of necrotizing fasciitis involving the lower lip as a consequence of infected skin acne in a 19 year old black female. The patient had been diagnosed earlier as a case of angioedema by a physician and treated accordingly. She was mildly anemic, hyponatremic and hypokalemic. Treatment was started immediately by incision, drainage and full debridement of the whole necrotic tissue. Triple antibiotic therapy was administered and daily irrigation and dressing were performed until full recovery. Complete healing occurred within a month by secondary intention. CONCLUSION: This case demonstrates the misdiagnosis of a lip swelling leading to the development of labiofacial necrotizing fasciitis, a serious and life threatening condition. Lip angioedema is a common condition; however, lip fasciitis is rare. A broad differential diagnosis in case of lower lip swelling is essential to avoid inappropriate treatment delay.