Main Article Content
Abstract
Cervico-facial cellulitis is extensive and are redoubtable polymicrobial infections because they can jeopardize the vital prognosis. Spreads to other regions of the face and neck are rare forms and have a poor prognosis. We report a case of thoracic and mammary spread of odontogenic cellulitis in a 39-year-old woman with no contributing antecedent. The signs were unremarkable at first. However, the clinical manifestations during the evolution were rapidly severe. The clinical signs consisted of an odynodysphagia, hypersialorrhoea, trismus, laryngeal dyspnoea, asthenia and fever. An intravenous antibiotic therapy based on Amoxicillin + Clavulanic acid and Metronidazole for 05 days, then modified to Ampicillin / Gentamycin / Metronidazole for 03 days due to financial difficulty. Oral relay with Amoxicillin + Clavulanic Acid and Levofloxacin was started on D8. Lifting of the trismus thanks to mechanotherapy with a cork stopper allowed the extraction of the causal tooth on D4. Drug treatment was associated with surgical drainage of abundant pus which emerged at the level of the neck, thorax and breasts, and in relation with an extensive necrosis of the neck and thorax. Under this intensive treatment, the evolution was favorable in twelve days with good healing thanks to natural honey.
ABSTRACT
Les cellulites cervico faciales sont des infections polymicrobiennes extensives et redoutables car pouvant mettre en jeu le pronostic vital. Les diffusions vers d’autres régions de la face et du cou sont des formes rares et de mauvais pronostic. Nous rapportons un cas de diffusion thoracique et mammaire d’une cellulite odontogène survenue chez une femme de 39ans sans antécédents contributifs. Les signes étaient peu évocateurs au début. Cependant les manifestations cliniques au cours de l’évolution étaient rapidement sévères. Les signes cliniques comportaient une odynodysphagie, une hypersialorrhée, un trismus, une dyspnée laryngée, une asthénie et de la fièvre. Une antibiothérapie intra veineuse à base d’amoxicilline + acide clavulanique et métronidazole pendant 05 jours puis modifiée par Ampicilline/ Gentamycine/ Métronidazole pendant 03 jours pour difficulté financière. Le relais oral fait d’Amoxicilline + Acide Clavulanique et Lévofloxacine a été instauré dès J8. La levée du trismus grâce à la mécanothérapie au bouchon de liège a permis l’extraction de la dent causale à J4. Le traitement médicamenteux était associé à un drainage chirurgical d’un pus abondant qui faisait issue au niveau du cou, du thorax et des seins, et en relation avec une nécrose extensive du cou et du thorax. Sous ce traitement intensif, l’évolution était favorable en douze jours avec une bonne cicatrisation grâce au miel naturel.
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References
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- Atanga léonel christophe, mballa, olive nicole ngaba, bohimbo jacques edouma, et al. Diagnosis, treatment and prognosis of cervico-facial cellulitis in yaoundé. Health sciences and disease.2020;6(21)
- El Ayoubi A, El Ayoubi F, Mas E, et al. Diffuse cervico-facial cellulitis of dental origin: about 60 cases. Med Buccale Chir Buccale 2009; 15: 127-35.
- BLONDEAU, Joseph M. The role of fluoroquinolones in skin and skin structure infections. American journal of clinical dermatology, 2002; 3:37-46.
- Ragot Ragot JP. Dental infectious foci and their complications. Practical Review 1998; 48: 1714-7.
- Kone, s. GN, et al. Treatment of wounds with honey in Abidjan. Medical Mali.2016;31(3)
- Deaulmerie, Emilie, et al. Healing by second intention: is honey a solution for the future to the problems of equine wounds? 2020.
References
Bengondo MC, Bita RC, Avang NTC, Mengong H, Bengono G. Cellulites and phlegmons of dental origin at the University Hospital of Yaoundé Rev. Odontostomatol. Tropical. 2006; 29 (113): 22-26.
Togo seydou et al. Infectious descending necrotizing cellulitis of dental origin with breast diffusion: analysis of two cases. (2016).
Rouadi, sami et al. Cervicofacial cellulitis about 130 cases. The pan african medical journal.2013; 88(14).
Njimah, amadou njifou, et al. Cervicofacial cellulitis in Cameroonian hospitals. health sciences and disease. 2014 ; 15(1).
Atanga léonel christophe, mballa, olive nicole ngaba, bohimbo jacques edouma, et al. Diagnosis, treatment and prognosis of cervico-facial cellulitis in yaoundé. Health sciences and disease.2020;6(21)
El Ayoubi A, El Ayoubi F, Mas E, et al. Diffuse cervico-facial cellulitis of dental origin: about 60 cases. Med Buccale Chir Buccale 2009; 15: 127-35.
BLONDEAU, Joseph M. The role of fluoroquinolones in skin and skin structure infections. American journal of clinical dermatology, 2002; 3:37-46.
Ragot Ragot JP. Dental infectious foci and their complications. Practical Review 1998; 48: 1714-7.
Kone, s. GN, et al. Treatment of wounds with honey in Abidjan. Medical Mali.2016;31(3)
Deaulmerie, Emilie, et al. Healing by second intention: is honey a solution for the future to the problems of equine wounds? 2020.