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Oropharyngeal sepsis with endothoracic spread
Summary
Oropharyngeal infections can spread to the chest via fascial planes, often originating from dental issues. Aggressive treatment including surgery and antibiotics is crucial to reduce the high mortality and aspiration pneumonia risks.
Area of Science:
- Medicine
- Infectious Diseases
- Surgical Pathology
Background:
- Oropharyngeal infections can present with rare but severe complications.
- Odontogenic infections are a common etiology for deep neck space infections.
Observation:
- Two cases of oropharyngeal infection extending into the thoracic cavity via fascial planes were identified.
- A literature review identified 14 additional cases with similar presentations over five years.
- The primary source of infection in most cases was odontogenic.
Findings:
- The overall mortality rate for this condition was 25% (4 out of 16 patients).
- Aspiration pneumonia occurred in 44% of patients due to transient swallowing dysfunction.
- Odontogenic infections are a significant cause of thoracic spread.
Implications:
- Prompt and aggressive surgical intervention is essential for patient survival.
- Appropriate antibiotic therapy must be administered to control the infection.
- Restricting oral intake and considering nasogastric tube feeding can mitigate aspiration pneumonia risk.