title: Infection from an exfoliating primary tooth in a child with severe neutropenia: a case report.
abstract: In patients with deficient immune defenses, a localized oral infection can progress to a systemic infection. The purpose of this paper was to describe the case of a child with acute lymphoblastic leukemia who presented with fever, trismus, and submandibular swelling in the absence of  the typical dental causes of infection such as deep dental caries or clinically significant periodontal disease. Treatment included an aggressive intravenous antibiotic regimen and extraction of the offending tooth after the recovery from bone marrow suppression.
authors.affiliation: Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA. chhong@umich.edu
authors.forename: Catherine
authors.initials: C
authors.lastname: Hong
authors.forename: Michael T
authors.initials: MT
authors.lastname: Brennan
authors.forename: Joel
authors.initials: J
authors.lastname: Kaplan
authors.forename: Peter B
authors.initials: PB
authors.lastname: Lockhart
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000077723:Cefepime; D002511:Cephalosporins / Q000008:administration & dosage; D002648:Child; D002981:Clindamycin / Q000008:administration & dosage; D004338:Drug Combinations; D005260:Female; D005491:Focal Infection, Dental / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007275:Injections, Intravenous; D015122:Mercaptopurine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D009503:Neutropenia / Q000150:complications; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D014080:Tooth Exfoliation; D014081:Tooth Extraction; D014094:Tooth, Deciduous / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D004338:Drug Combinations; D002981:Clindamycin; D000077723:Cefepime; D015122:Mercaptopurine; D008727:Methotrexate