60year old male,Known Diabetic on Rx,presented as a case of Intra oral/Facial abscess with Facial cellulitis Incision and drainage performed Intra orally with wound Lavage Patient symptomatically improving Does Intra oral drainage is advisable in facial abscess?



If the cause is intra oral like spreading infection from gum teeth ,It is better to go for intra oral drainage of pus followed by broad spectrum antibiotic, Strict glycaemic control.

The question is regarding choice whether intraoral drainage should be done or not Absolutely the decision is site of abscess dependent it can be done with precautionary measures so as infection should not seepage in respiratory tract and as pt is diabetic aspiration pneumonitis will be more dangerous than abscess so keep monitoring and diabetes in strict control My question is why external drainage was not chosen is it a cosmetic reason or else.

Thanx dr Dhilipan Pradap Rangraju

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First of all find out the cause of cellulitis. Start with broad spectrum antibiotic and analgesic. Hospitalization if necessary Check for space infection and or any odontogenic infection. Advive an opg and go for ct scan. Advice patient to maintain sugar level.

Definitive treatment includes airway management , optimization of pre-existing medical condition diabetes prior to removal of source of infection and drainage of pus.High doses of intravenous antibiotics should be administered with the initial choice of antibiotics modified in the light of bacteriological reports.The treatment of all odontogenic infection must include removal of the focus of infection and drainage of pus

Abscess in this area is always dangerous as cellulitis rapidly spreads to surrounding vital areas. As patient is diabetic- achieve strict glycemic control with insulin. Case has been managed nicely. Intraoral drainage sometimes can cause drainage fluid going in respiratory passages while sleeping and causing aspiration. Better is,skin drainage- but then it can cause a scar

This is space infection due to decayed rt upper quadrant tooth specifically canine, if u did intra oral examination u can found out it, and the management should be. I and D, broad spectrum antibiotic, extraction of offending tooth with good glycemic control

Intra oral drainage has advantage of not leaving a facial scar Tight control of DM ,broad spectrum antibiotics, metronidazole, Flucanazole are important components. Fully conscious, well oriented patients will do well with intraoral drainage

Start with antibiotics..then go for drainage..and MGT of affending tooth

Interesting case Nicely managed

Orbital cellulitis????

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