Orbital abscess arising from an odontogenic infection

Presenting a rare complication of an odontogenic infection extending to the orbit.

A 45-year-old male patient reported with periorbital swelling of eyelids, of the left eye, foul smelling nasal discharge and a pus draining sinus on the left lower eyelid area.

The patient gave history of pain in the left upper first molar tooth 1 week back. His intraoral examination showed poor oral hygiene with tenderness on percussion on the left maxillary first molar. Investigations showed possible extension of infection from left maxillary molar root to maxillary sinus and to the orbital floor.

A case of periapical infection of a maxillary left molar resulting in an orbital abscess is presented. Identification of odontogenic source of infections, institution of drainage, removal of offending teeth and appropriate antimicrobial therapy are mandatory in preventing loss of vision and cerebral extensions. The pathways of spread of the infection, treatment aspects, are discussed and complications are reviewed.