A case of a patient with severe odontogenic phlegmon of the neck (as caused by Streptococcus anginosus and Prevotella intermedia) associated with mixed systemic infection (sepsis) and pneumonia

Abstract

Introduction: Among numerous acute inflammatory processes within the organs and structures of the neck, special attention is paid to the phlegmon, i.e. diffuse purulent infection of the soft tissues of the neck, which poses a serious threat to the life of the affected individual. Case report: Presented herein is a case study of a patient with severe odontogenic phlegmon accompanied by mixed systemic infection (sepsis) and pneumonia. The patient had undergone several surgical procedures. Respiratory and circulatory support with broad-spectrum antibiotic therapy (empirical followed by targeted) were administered in analgosedation within an ICU setting. Following the stabilization of vital signs, the treatment was continued within the Department of Laryngology. The authors have reviewed the available literature on the etiology, diagnostics, and treatment of severe, odontogenic infections of the soft tissues of the neck, with particular emphasis on infections caused by Streptococcus anginosus and Prevotella intermedia. Conclusions: The correct choice of management tactics in case of an advanced purulent inflammatory process within the cervicofacial region is of utmost importance for the treatment outcomes as well as for the saving of the patient’s life. Literature reports highlight the need for early detection and urgent surgical treatment of Streptococcus anginosus infections due to the aggressive course of infections caused by this pathogen species.