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Recurrent Fever of Unknown Origin Associated with Forgotten Dental Root Infection in a Geriatric Patient

DOI: 
10.7727/wimj.2017.012

ABSTRACT

We report a rare clinical condition caused by odontogenic infections; unexplained or recurrent fever related to dental abscess. 

An 85-year-old female patient plagued with recurrent fever, lasted for more than 10 months, had been hospitalized on five occasions for diagnosis and treatment. After rigorous physical examinations, laboratory and radiological investigations, we established an infected left maxillary canine root inside her upper premaxilla, which had been forgotten during a dental procedure 10 years ago. Although there were no signs of inflammation on the panoramic radiography, the oral surgeon noted an abscess formation right beside the dental root upon extraction of the root. We cleared the inside of the upper palate and took bacterial cultures of the abscess. The sample material was directly inoculated into blood culture bottles. Granulicatella adiacens was recovered from the cultures. The patient made a full recovery subsequent to drainage of the abscess, extraction of the forgotten dental root, and antibiotic treatment.

Early dental evaluation and referral of patients with persistent and recurrent fever (even without any oral symptoms) to a dentist has a critical role to prevent unnecessary, time-consuming further diagnostic tests and invasive procedures. A simple panoramic radiography may be useful to establish the diagnosis.

Accepted: 
14 Mar, 2017
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e-Published: 22 Mar, 2017

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