Submandibular Cellulitis Caused by Odontogenic Infection Concomitant with Endogenous Endophthalmitis and Lung Abscess

Abstract

A 61-year-old man with untreated diabetes mellitus had submandibular cellulitis caused by an odontogenic infection concomitant with endophthalmitis and a lung abscess. Computed tomography showed masses in the right submandibular and lung regions. A biopsy of the anterior chamber aqueous indicated endophthalmitis. The masses in the submandibular and lung regions improved following systemic antibiotic therapy and extraction of the right mandibular molars, the initial symptom in this episode. Although the patient's right eye pain improved, visual acuity did not recover. Cultures from the aqueous and blood were negative. There were no signs of spread of infection to the maxillary sinus, pterygopalatine fossa, and orbit. As there was no inflammatory pathway, it was suggested that haematogenous spread of bacteria had caused inflammatory spread.