A case of facial erysipelas suspected to be caused by odontogenic infection

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  • 歯性感染症が原因と疑われた顔面丹毒の一例
  • シセイ カンセンショウ ガ ゲンイン ト ウタガワレタ ガンメン タンドク ノ イチレイ

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Abstract

Erysipelas is a pyogenic inflammatory disease of the dermis characterized by erythema with edema appearing on the skin with fever. However, there have been few reports of facial erysipelas caused by dental infection. In this report, we describe a case of erysipelas of the face that was suspected to have been caused by periodontitis of the right maxillary canine tooth. The patient was a 67-year-old woman. She was referred to our department because of right-sided facial swelling. At the time of initial examination, erythema and swelling with well-defined borders were observed from the lower right orbit to the right cheek and lower right side of the jaw. We initially diagnosed her disease as buccal cellulitis caused by periodontitis of the right maxillary canine tooth and therefore performed incisional drainage. However, because there was no drainage of pus, we suspected erysipelas as a differential diagnosis. After consultation with a dermatologist, the patient was diagnosed with facial erysipelas. The swelling in the right cheek area and discomfort in the right maxillary canine tooth persisted after administration of antibacterial drugs; therefore, we created a root canal opening in the right maxillary canine tooth. Eleven days after symptom onset, the erythema on the right side of the face disappeared. After about 2 months, the patient was doing well without any recurrence.

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