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Case Reports
. 2017 Apr 28:2017:bcr2016218560.
doi: 10.1136/bcr-2016-218560.

Odontogenic abscess mimicking acute dacryocystitis

Ahmad M Mansour  1   2 , Wajiha Kheir-Jurdi  1 , Usamah El Hadi  3 , Ghassan Awar  4
Affiliations
Case Reports

Odontogenic abscess mimicking acute dacryocystitis

Ahmad M Mansour et al. BMJ Case Rep. .

Abstract

A middle-aged poorly controlled diabetic man developed left-sided orbital and facial swelling several days after extraction of a left upper wisdom tooth. The clinical impression was that of acute dacryocystitis. Opening the skin above the lacrimal sac failed to reveal an inflamed sac establishing the diagnosis of deep facial cellulitis. Complete resolution occurred few weeks after systemic antibiotics and repeated dental drainage of the tooth abscess.

Keywords: Dentistry and oral medicine; Drugs: infectious diseases; Ear, nose and throat; Infections; Ophthalmology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
External appearance on presentation with left facial swelling (A), 3 days later with severe medial canthal erythema and swelling (B), 5 days later pus is draining from the medial canthal area mimicking acute dacryocystitis) (C). There was a complete resolution of erythema and swelling of the left face a month later (D).
Figure 2
Figure 2
Axial CT of the orbit reveals swelling around the lacrimal sac on the left side with normal orbits (A) with severe tissue swelling around the left upper jaw and abscess formation on coronal view (B).
Figure 3
Figure 3
MR face with contrast. (A) Soft tissue swelling around the left lacrimal sac. (B and C) Left facial swelling extending from the submandibular space to the left cheek, with multiple septate and loculated collections (red arrows). The lucency around the root of the left third molar is in keeping with a dental abscess (black arrow).
See this image and copyright information in PMC

References

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