歯性感染に起因したと思われる顔面静脈血栓性静脈炎の1例

• Published in: 日本口腔外科学会雑誌 Vol. 66; no. 3; pp. 141 - 146
• Main Authors: 西村, 奈穂, 鈴木, 真央, 毛利, 真弥, 浜口, 裕弘
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.03.2020
• Subjects: 歯性感染症; 血栓性静脈炎; 顔面静脈
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.66.141

We report our experience with a patient who had thrombophlebitis of the facial vein, which might have been caused by odontogenic infection of the mandibular first molar. A 64-year-old woman presented at our hospital because of swelling of the left cheek.　Although she received antibiotics from her family dentist for gingival swelling at the left mandibular first molar, her symptoms have exacerbated. At the initial visit to our department, she had diffuse swelling and tenderness from the first molar region to the buccal mucosa. Panoramic radiography showed alveolar bone resorption around the first molar, and cellulitis in the left cheek caused by periodontitis of the first molar region was diagnosed. After the start of continuous intravenous administration of antibiotics, swelling of the left cheek remitted. However, swelling and redness around the left orbit worsened, and contrast-enhanced computed tomography was performed. The findings of poor contrast effect, blood vessel wall thickening and an area of no visualized lumen were observed in the left facial vein. Thus, the diagnosis of thrombophlebitis in the left facial vein was established, and secondary optic neuritis was suspected. Consequently, the patient successfully received continuous intravenous administration of Cefmetazole given for 5 days, which is effective against anaerobic bacteria, followed by 2-week oral administration of Amoxicillin hydrate and potassium clavulanate and 3-month anticoagulant treatment with oral Apixaban.