Life threatening complications from a lower wisdom tooth

The case history of a 25-year-old student who developed a number of very serious complications after a simple extraction of a lower wisdom tooth is presented. A submandibular abscess was followed by septic shock with severe thrombocytopenia and transient renal insufficiency, adult respiratory distress syndrome, pneumothorax and pericarditis. From the blood, alpha-hemolytic Streptococci were cultured, while cultures from the abscess grew Bacteroides fragilis. With intensive treatment, including artificial ventilation with PEEP, the patient survived this life-threatening episode.