Cervicofacial Infections Caused by Staphylococcus aureus

Abstract

Staphylococcus aureus (S. aureus) is an opportunistic pathogen that causes a wide range of diseases. Dissemination of perioral infections is a common problem in the field of oral and maxillofacial surgery. The aim of the study was to evaluate S. aureus carriage in the oral cavity and its dissemination to different cervicofacial regions. Clinical case 1 is a patient with a systemic history of type I diabetes which led to foot amputation one year previou sly, who presented alteration of ocular motility and the culture showed Grampositive cocci compatible with S. aureus. The patient was discharged after eight days of antibiotic therapy and drainage. Clinical case 2 was a young female without any comorbidities who had never been hospitalized before or even exposed to the hospital environment. The presence of lesions compatible with necrotizing fasciitis (NF) in the lower lip mucosal region, rapid evolution of the infection to deep planes, and evolution of the clinical picture alerted health-care providers to the need for prompt care. Clinical case 3 was an immunosuppressed patient with cellulitis which is a bacterial infection of the skin and soft tissues that occurs when the physical barrier of the skin and soft tissues, the immune system, and/or the circulatory system are affected. S. aureus is an opportunistic pathogen which causes a wide range of diseases. It inhabits the oral cavity, from where it can spread to distant cervicofacial regions. This is why it is important for health-care professionals to be aware of this niche in case of dissemination in order to provide prompt diagnosis and appropriate treatment.

Keywords: Dissemination; Staphylococcus aureus; opportunistic microorganisms.

Figure 1

(a) Case 1, Right orbital abscess. (b) Case 2, Increase in volume in the labial, submental, and submaxillary regions. Presence of crusts in lower labial half-mucous. (c) Case 3, Volume increase of the right submaxillary region, with purulent secretion

Figure 2

(a) Case 1, Axial computed tomography of the craniofacial massif. Purulent collection is observed. (b) Case 2, Ulcer in mucosa of the lower lip with multiple foci of tissue necrosis. (c) Case 3, Favorable postoperative evolution

Figure 3

(a) Case 1, After the drainage surgery, some laminar drains are placed (b) Case 2, Computed axial tomography of the craniofacial massif. Hypodense image of diffuse contours in the submental and submaxillary regions

Figure 4

(a) Case 1, Favorable postoperative evolution. (b) Case 2, Computed axial tomography of the craniofacial massif. Hypodense image of diffuse contours in the submental and submaxillary regions

Figure 5

Case 2, Surgical debridement of necrotizing fasciitis

Figure 6

Case 2, Laminar drains in the submental region

Figure 7

Case 2, Postoperative. 3 days after surgery

Figure 8

Case 2, Favorable postoperative evolution of the inferior labial semi-mucosa

Figure 9

Case 2, Favorable postoperative evolution of the mucosa inferior labial