[34F] With severe facial pain, swelling, and numbness post-tooth fracture

Patient Description

A 34-year-old female is experiencing severe sharp and throbbing pain, swelling, and numbness in the face following a tooth fracture. The pain began gradually over 5 days and is accompanied by discharge or pus from the affected area, fever, and chills. Despite taking ibuprofen and antibiotics (amoxicillin), there has been no improvement in symptoms. The numbness, which started 2 days ago, involves a complete loss of feeling and difficulty in opening the eye fully. The patient has a history of lupus and Ehlers-Danlos Syndrome and has previously had sepsis from a tooth abscess 6 years ago. Current medications include ibuprofen (800mg every 6 hours), amoxicillin (500mg 3 times a day), propranolol (120mg once a day), gabapentin (400mg 4 times a day), and sertraline (once a day). No known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, there are several serious conditions that could be causing your symptoms:

  1. Dental Abscess Complications: A tooth abscess is a pocket of pus caused by a bacterial infection. Given your severe pain, swelling, and discharge, it is likely that the infection has not been adequately controlled by the antibiotics. This can lead to more serious complications, such as the spread of infection to surrounding tissues.

  2. Facial Cellulitis: The swelling and numbness in your face, along with the inability to open your eye, suggest that the infection may have spread to the soft tissues of your face, a condition known as cellulitis. This can be very serious and requires immediate medical attention.

  3. Sepsis: Given your history of sepsis from a tooth abscess, and your current symptoms of fever and chills, there is a risk that the infection could be spreading to your bloodstream again, leading to sepsis. This is a life-threatening condition that requires urgent medical care.

What you can do

  1. Seek Immediate Medical Attention: Given the severity of your symptoms and your history of sepsis, it is crucial that you seek immediate medical attention. Go to the nearest emergency room or urgent care center as soon as possible. If you are unable to get there yourself, call 911 or have someone drive you.

  2. Monitor Symptoms: While you are waiting for medical help, keep an eye on your symptoms. If you notice any worsening of your condition, such as increased swelling, difficulty breathing, or confusion, inform the medical staff immediately.

  3. Continue Medications: Continue taking your prescribed medications, including the antibiotics, as directed by your healthcare provider. However, do not rely solely on these medications to manage your condition, as you need professional medical evaluation and possibly more intensive treatment.

  4. Stay Hydrated: Drink plenty of fluids to stay hydrated, especially if you have a fever. This can help support your body while it fights the infection.

Remember, I am not a doctor, and this advice is based on the information you have provided. It is essential to seek care from real health professionals to receive a formal diagnosis and appropriate treatment. Your health and safety are the top priority.

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3 mo ago

People Also Ask

What are the signs and symptoms of a dental abscess?

A dental abscess typically presents with severe toothache, sensitivity to hot and cold, swelling in the face or cheek, fever, and a bad taste in the mouth due to pus discharge. If left untreated, it can lead to more serious complications.

How can a dental infection lead to facial cellulitis?

A dental infection can spread to the soft tissues of the face, leading to cellulitis, which is characterized by redness, swelling, warmth, and pain in the affected area. This can cause numbness and difficulty in moving facial muscles, and requires immediate medical attention.

What are the risks of sepsis from a dental infection?

Sepsis is a life-threatening condition that occurs when the body's response to an infection causes injury to its own tissues and organs. A dental infection can enter the bloodstream, leading to sepsis, which is marked by fever, chills, rapid breathing, and confusion. It requires urgent medical treatment.

Why might antibiotics not be effective in treating a dental abscess?

Antibiotics may not be effective if the infection is resistant to the medication, if the abscess is not adequately drained, or if the infection has spread beyond the reach of the antibiotics. In such cases, further medical intervention is necessary.

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