We report the case of a three-year-old girl who came to the Primary Care clinic for three days suffering from toothache and mild dental phlegmon, without fever.
1.
The examination revealed caries in the second molar of right lower milk, with mild inflammation and jaw pain.
It was decided to start antibiotic treatment with amoxicillin at high doses, and the dentist was indicated.
It is reviewed in consultation after four days.
Phlegmon and regional lymphadenopathy persist, but there is no pain.
It was decided to continue with the treatment and control.
After one week of treatment the phlegmon is more delimited and with pain, so it is derived to maxillofacial surgery.
That same afternoon she has fever, so she is referred to the emergency department, where they decide to treat amoxicillin plus clavulanic acid and go to the dentist.
At 20 days in primary care presents abscess in right submandibular edge, red, painful and suppurative.
She is referred back to the Emergency Department for drainage.
It drains and samples are taken for culture and pathology of the ulcerated cervical lesion.
Antibiotics were administered with ciprofloxacin.
1.
The pathology result describes granulation tissue with acute and chronic inflammation and central necrosis, without observing microorganisms (with techniques Grocot, Gram and Ziehl-Neelsen) and no lymph node remnants.
The evolution of the ulcer is torpid, with healing every two days in the health center.
One month after drainage extraction was performed, obtaining definitive improvement after two months of evolution.
The large scar on the face starts moving in.
