Advertisement

Oral Radiology

, Volume 34, Issue 1, pp 83–87 | Cite as

Gas gangrene in the deep spaces of the head and neck visualized on computed tomography images

  • Shoko GamohEmail author
  • Kaname Tsuji
  • Hugo Maruyama
  • Hiroyuki Hamada
  • Hironori Akiyama
  • Isumi Toda
  • Pao-Li Wang
  • Shosuke Morita
  • Kimishige Shimizutani
Case Report

Abstract

Cellulitis accompanied by gas gangrene is a rapidly-spreading and potentially fatal infection. Here, we present a case of gas gangrene in the deep spaces of the head and neck in an elderly woman, diagnosed by computed tomography (CT). An 86-year-old woman with Alzheimer’s disease, hypertension, hyperlipidemia, and osteoporosis was referred to our institute by her local dentist. The patient exhibited trismus caused by severe swelling in the left submandibular area. CT images of the head and neck area showed swelling of the cervical tissue with air in the parapharyngeal and masticator spaces. She was treated with antibiotics, followed by drainage. Although the therapy was continued, the patient died from a cardiac complication on hospital day 42. Our case highlights the usefulness of CT for diagnosing gas gangrene in the deep spaces of the head and neck in a woman with Alzheimer’s disease.

Keywords

Gas gangrene Dental infection Computed tomography Parapharyngeal space Alzheimer’s disease 

Notes

Compliance with ethical standards

Conflict of interest

Shoko Gamoh, Kaname Tsuji, Hugo Maruyama, Hiroyuki Hamada, Hironori Akiyama, Isumi Toda, Pao-Li Wang, Shosuke Morita, and Kimishige Shimizutani declare that they have no conflict of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from the patient for being included in the study.

References

  1. 1.
    Moghimi M, Baart JA, Karagozoglu KH, Forouzanfar T. Spread of odontogenic infections: a retrospective analysis and review of the literature. Quintessence Int. 2013;44:351–61.PubMedGoogle Scholar
  2. 2.
    Bratton TA, Jackson DC, Nkungula-Howlett T, Williams CW, Bennett CR. Management of complex multi-space odontogenic infections. J Tenn Dent Assoc. 2002;82:39–47.PubMedGoogle Scholar
  3. 3.
    Kawagoe H, Yoshii T, Ohtsuka Y, Takenono I, Teranobu O, Komori T. Death due to cervical gas gangrene following tooth extraction of mandibular third molar—report of a case. Oral Ther Pharmacol. 1999;18:139–43.Google Scholar
  4. 4.
    Kiddee W, Preechawai P, Hirunpat S. Bilateral septic cavernous sinus thrombosis following the masticator and parapharyngeal space infection from the odontogenic origin: a case report. J Med Assoc Thai. 2010;93:1107–11.PubMedGoogle Scholar
  5. 5.
    Winblad B, Gauthier S, Astrom D, Stender K. Memantine benefits functional abilities in moderate to severe Alzheimer’s disease. J Nutr Health Aging. 2010;14:770–4.CrossRefPubMedGoogle Scholar
  6. 6.
    Harnsberger HR. The oral cavity: emphasizing the sublingual and submandibular spaces. 2nd ed. Salt Lake City: Mosby; 1995. p. 132.Google Scholar
  7. 7.
    Takazawa K, Otsuka H, Nakagawa Y, Inokuchi S. Clinical features of non-clostridial gas gangrene and risk factors for in-hospital mortality. Tokai J Exp Clin Med. 2015;40:124–9.PubMedGoogle Scholar
  8. 8.
    Akamatsu H, Sano T, Hayashi T, Shima M, Oishi K. A case of gas gangrene by odontogenic infection. J Jpn Soc Oral Tumors. 2008;21:112–6.Google Scholar
  9. 9.
    Tsuchiya Y, Noguchi T, Shinozaki Y, Ito H, Jinbu Y, Kusama M. A case of orbital abscess with gas gangrene caused by odontogenic infection. Jpn J Oral Maxillofac Surg. 2012;58:67–71.CrossRefGoogle Scholar
  10. 10.
    De A, Varaiya A, Mathur M, Bhesania A. Bacteriological studies of gas gangrene and related infections. Indian J Med Microbiol. 2003;21:202–4.PubMedGoogle Scholar

Copyright information

© Japanese Society for Oral and Maxillofacial Radiology and Springer Japan 2017

Authors and Affiliations

  • Shoko Gamoh
    • 1
    Email author
  • Kaname Tsuji
    • 2
  • Hugo Maruyama
    • 3
  • Hiroyuki Hamada
    • 4
  • Hironori Akiyama
    • 1
  • Isumi Toda
    • 5
  • Pao-Li Wang
    • 3
  • Shosuke Morita
    • 2
  • Kimishige Shimizutani
    • 1
  1. 1.Department of Oral RadiologyOsaka Dental UniversityOsakaJapan
  2. 2.First Department of Oral and Maxillofacial SurgeryOsaka Dental UniversityOsakaJapan
  3. 3.Department of BacteriologyOsaka Dental UniversityHirakataJapan
  4. 4.Department of Oral and Maxillofacial SurgeryNational Hospital Organization Osaka National HospitalOsakaJapan
  5. 5.Department of AnatomyOsaka Dental UniversityHirakataJapan

Personalised recommendations