Odontogenic sinusitis causing orbital cellulitis.
BACKGROUND
Odontogenic sinusitis is a well-recognized condition that usually is responsive to standard medical and surgical treatment. Current antibiotic therapy recommendations are directed against the usual odontogenic and sinus flora.


METHODS
The authors present a case of a patient with acute sinusitis initiated by a complicated tooth extraction that did not yield readily to standard treatment. The case was complicated by orbital extension of the sinusitis. The authors isolated methicillin-resistant Staphylococcus aureus, or MRSA, species from the affected sinus that usually is not encountered in uncomplicated acute nonnosocomial or odontogenic sinusitis.


CONCLUSIONS
Though such forms of resistant microbial flora as MRSA are rare, they may be seen in patients who have a history of intravenous, or i.v., drug use and in immunocompromised patients. Management of patients with orbital extension of sinusitis requires hospitalization and i.v. antibiotic treatment.
Mehra
P
P
Boston University-Tufts University Oral and Maxillofacial Surgery Programs, USA.
Caiazzo
A
A
Bestgen
S
S
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002481:Cellulitis / Q000188:drug therapy / Q000209:etiology; D005547:Foreign Bodies / Q000150:complications; D006801:Humans; D008297:Male; D008443:Maxillary Sinus; D015523:Maxillary Sinusitis / Q000150:complications* / Q000209:etiology* / Q000382:microbiology; D016106:Methicillin Resistance; D009916:Orbital Diseases / Q000188:drug therapy / Q000209:etiology*; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects; D014081:Tooth Extraction / Q000009:adverse effects*; D014092:Tooth Root; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014640:Vancomycin; D002443:Ceftriaxone