PLEURAL EMPYEMA ASSOCIATED WITH SUBMANDIBULAR ABSCESS: CASE REPORT FROM A HOSPITAL IN THE ECUADORIAN AMAZON

Abstract

INTRODUCTION

Pleural effusion is a pathology product of the overproduction of said fluid and decreased absorption. Transudate-type effusions are produced by general alteration of formation and absorption, as in the case of cirrhosis or heart failure. Exudate-type pleural effusions are usually caused by local alterations that affect physiology, such as pneumonia, neoplasms or pulmonary embolisms. The origin of the liquid in the present clinical case comes from the presence of an infectious process located in the sub-mandibular region, due to the poor hygiene and oral care of the patient, which leads him to present a bacterial pneumonia, which evolves to an empyema.

CLINICAL CASE

The case of a 43-years-old patient, treated in a Morona Santiago Hospital, with a history of chronic alcoholism, with symptoms of oral cavity pain of moderate intensity, associated with purulent flux in moderate quantity, which continues unfavorably with non-productive cough and pleuritic pain. Complementary studies are made in this patient, what shows the presence of Pleural Empyema and Submandibular Abscess

EVOLUTION

The patient was treated with broad-spectrum antibiotics, vasoactive support because of the presence of septic shock and the treatment of oral problems. Furthermore, X-ray images and CT scans had been made to confirm critical clinic status of the patient. Nevertheless, the patient requests medical discharge to go to another private and more complex health unit.

CONCLUSIONS

Neck abscesses are the product of dental alterations that, if not treated immediately, are strongly predisposing to infections in other regions of the body, due to dissemination, such as: lung, mediastinum and pericardium. The different causes of empyema are of vital importance, because diagnosing the possible etiologies of empyema can lead us to correct management and treatment, and more directed towards the cause.