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Save the life of a case of severe purulent cellulitis in the cheek area in a 1.5-month-old baby

Recently, City Children’s Hospital received an LH Ph. 1.5 months, male, living in Chau Thanh, Tien Giang. Taking the medical history, the child was sick for 5 days with fever, swelling of the eyes, right cheek, examination and treatment at the local hospital, so the family took the child to the City Children’s Hospital.

Here, the doctor examined the child and noted that the child had a high fever continuously, the right cheek area was red and swollen spreading to the right eye, the right forehead area, examination of the oral cavity and pharynx showed that the pus-filled mass in the upper jaw area had spread. Anterior to the right upper gingival arch, there was a fistula of pus inside the maxillary region, exuding yellow pus, which was taken as a bacterial culture test. Children were given broad-spectrum antibiotics initially, adjusted water and electrolytes, and reduced fever. The result of pus culture is methicillin-resistant Staphylococcus aureus, a highly resistant, “stubborn” cocci with appropriate antibiotics for this bacterium. Children were given the appropriate antibiotic vancomycin and the appropriate dose adjusted based on measurement of the trough and peak concentrations of vancomycin in the blood. However, the child’s progress was not favorable, the fever was high continuously, the cellulitis in the cheekbone area continued to swell and spread, the child had a CT scan of the maxillofacial region, recorded a collection of pus in the right cheekbone that had eaten into the jawbone. top right, spread forward. Children were consulted by specialists of Ear, Nose, Throat, Teeth, Maxillofacial, and performed an incision to drain the pus from the upper gum area in front, aspirate the pus and let the child wash and suck the pus every day.

  Preventing common accidents

The results after nearly a month of treatment, the child’s condition improved gradually, the swelling of the cheekbones was reduced, the eyes were less swollen and opened well, and the baby suckled quite well. It is known that bottle-fed babies because mothers have little milk and inadequate oral gum care can lead to infections in the oral cavity leading to purulent cellulitis. Through this case, we would like to note that young children also need to clean their mouths with physiological saline or cold cooked water like brushing their teeth in older children, and make the most of breast milk for their children so that they can be properly nourished. the best care and protection.

Children with severe purulent cellulitis in the right cheek area, causing redness and swelling, spreading to the right eye
Children with severe purulent cellulitis in the right cheek area, causing redness and swelling, spreading to the right eye
The child recovered after nearly a month of active treatment and received follow-up treatment by appointment
The child recovered after nearly a month of active treatment and received follow-up treatment by appointment

Doctor of CK2 Nguyen Minh Tien
City Children’s Hospital


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