References

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Swelling Misattributed to an Infected Tooth Socket

From Volume 51, Issue 11, December 2024 | Pages 786-787

Authors

Migle Mazurkeviciute

BDS(Hons), MFDS, General Professional Trainee (GPT); Newcastle upon Tyne Hospitals NHS Foundation Trust

Articles by Migle Mazurkeviciute

Email Migle Mazurkeviciute

Grace Toon

BDS, MFDS, RCPS, PGCert, Specialty Doctor, Oral and Maxillofacial Surgery; Newcastle upon Tyne Hospitals NHS Foundation Trust

Articles by Grace Toon

Emily Carter

BDS, MFDS RCSEd, Dip Con Sed, CILT, AFHEA, MOS RCSEd

BDS, MFDS, Dip Con Sed, CILT, AFHEA, MOralSurg, Specialist Oral Surgeon, Clinical Lead, Dental Emergency Clinic; Newcastle upon Tyne Hospitals NHS Foundation Trust

Articles by Emily Carter

Abstract

This is a case report of a patient seen on the dental emergency clinic that describes ophthalmic shingles reactivation soon after a tooth extraction with the potential to have led to a misdiagnosis of the condition. This can potentially have serious consequences, including effects on vision. This case report emphasizes the importance of a thorough history and careful examination when a patient presents in an urgent setting.

CPD/Clinical Relevance:

The importance of a thorough history and careful examination is highlighted.

Article

A 50-year-old female patient presented post-operatively at the dental emergency clinic with a significant facial swelling affecting her left upper cheek and peri-orbital area. Relevant medical history included treatment for long-standing rheumatoid arthritis with methotrexate.

The patient had initially attended 9 days prior for an extraction of the UL6 owing to irreversible pulpitis, and then again 5 days post-operatively because of the worsening pain. At this point, the suppuration from the socket led to a diagnosis of a post-operative infection, and which was managed with socket irrigation and oral antibiotics.

On the third visit to the clinic, 9 days post-extraction (and therefore, 4 days after starting antibiotics), the patient complained of swelling around her eye, which had been getting worse for a few days and the eye was now difficult to open (Figure 1). She also complained of ‘spots which have stuff coming out of them’ on the face, referring to a clear discharge. The patient felt sure that the extraction had caused the swelling.

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