Facial Candida albicans cellulitis occurring in a patient with oral submucous fibrosis and unknown diabetes mellitus after local corticosteroid injection treatment.
Facial cellulitis caused by odontogenic bacterial infection is frequently encountered; however, facial cellulitis caused by Candida albicans infection is rarely found. A patient with oral submucous fibrosis (OSF) and unknown diabetes mellitus (DM) was treated in our out-patient dental clinic by biweekly submucosal injection of 40 mg triamcinolone acetonide into bilateral buccal mucosae plus forced mouth opening performed by the two hands of the clinician. The interincisal distance of the patient improved from 28 to 48 mm after four times of steroid injection. The symptoms and signs of OSF also improved markedly. Unfortunately, facial candidal cellulitis occurred 2 months after the last time of steroid injection treatment. The infection was cured by incision and drainage, intravenous administration of amphotericin B (100 mg once a day for a week), and an appropriate medical control of DM. No recurrence of facial cellulitis was found during the follow-up period of 18 months. To prevent the occurrence of facial cellulitis after a high-dose steroid therapy, some prophylactic procedures should be taken before the initiation of the steroid treatment.
Chen
Hsin-Ming
HM
School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan.
Shih
Chiang-Ching
CC
Yen
K Lawrence
KL
Wang
Sheng-Ming
SM
Kuo
Ying-Shiung
YS
Kuo
Mark Yen-Ping
MY
Chiang
Chun-Pin
CP
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000175:diagnosis*; D002481:Cellulitis / Q000382:microbiology*; D048909:Diabetes Complications; D004322:Drainage; D005145:Face / Q000382:microbiology*; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009914:Oral Submucous Fibrosis / Q000150:complications* / Q000188:drug therapy; D014222:Triamcinolone Acetonide / Q000009:adverse effects*
D000935:Antifungal Agents; D005938:Glucocorticoids; D000666:Amphotericin B; D014222:Triamcinolone Acetonide