A severe deep neck odontogenic infection not prioritised by the emergency department triage system and National Early Warning Score. (7th May 2018)

• Record Type: Journal Article
• Authors: Wates, Emma; Higginson, James; Kichenaradjou, Andre; McVeigh, Kieron
• Is Part Of: BMJ case reports. Volume 2018
• Publication Date: 2018-05-07
• Subjects: dentistry and oral medicine -- ear, nose and throat/otolaryngology -- anaesthesia; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-224634
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A 62-year-old man with a background of type 2 diabetes mellitus presented to the emergency department (ED) with a 5-day history of dental pain, progressive right facial swelling, trismus, dysphagia and voice changes. The oropharynx could not be directly examined completely due to trismus. The patient had a National Early Warning Score of 0 and so was triaged into the 'minors' section of ED. Following assessment by the on-call oral and maxillofacial surgeon, an urgent contrast-enhanced CT demonstrated a large parapharyngeal collection, which required urgent anaesthetic and surgical intervention. The patient developed pulmonary complications postoperatively, but eventually made a full recovery.