抜歯が誘因と考えられた硬膜外膿瘍の1症例

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We reported a case of epidural abscess which was induced by tooth extraction.<BR>A 59-year-old man was referred to our hospital due to a complaint of pain and swelling that extended from the left cheek to the temporal region. After admission, we started an intravenous regimen of latamoxef, 2g/day. After three hours, we observed a sudden pulasatory discharge of bloody, serous pus with an odor of putrefaction from the left ear. We found marked swelling that involved the left medial pterygoid muscle, masseter muscle, parotid gland, and subcutaneous tissue from the left tempora to the neck on computed tomography. We also found an epidural abscess containing air that extended from the left pterygopalatine fossa to the middle cranial fossa. After consulting an otorhinolaryngologist and a neurosurgeon, we decided to treat the patient conservatively with massive doses of systemic antibiotics. The epidural abscess disappeared by the 86th hospital day. The patient has had sequelae and his prognosis is excellent.