[Severe form of odontogenic sepsis--a case report]

One of possible and diagnostically difficult sources of bacterial sepsis may be purulent foci of odontogenic character. We present the case of a pregnant woman, in whom untreated purulent focus within oral cavity led to severe systemic infection. The disease was characterized by persistent hectic fever with accompanying features of intravascular coagulation, anemia and erythema nodosum and no response to antibiotic treatment. It was the second episode of sepsis in this patient in a period of one year, the source of the infectious process not being recognized previously. Dental examination revealed presence of the apical abscess of the tooth 6-, extraction of which led to spectacular clinical improvement, accompanied by the healing of erythema nodosum. The clinical course and outcome of the disease strongly supports odontogenic etiology, in spite of the lack of full microbiological confirmation. Purulent foci within oral cavity, including apical abscesses, constitute significant clinical problem and must be taken into consideration as a potential source of severe and recurrent systemic infections.