The masticator space infection.

ABSTRACT

The masticator space is an important suprahyoid tissue compartment. Infection of the masticator space can break through the fascia and involve the adjacent space. Severe complications including mediastinitis, pericarditis and death have been reported. The correct diagnosis and proper management are, therefore, crucial in order to reduce this complication. The authors reviewed 22 patients with masticator space infection between July 1996 and June 2001. All of the patients presented with trismus and 18 patients (81.8%) had a suspected dental cause of infection. Five patients had underlying disease; three were diabetic and two had human immunodeficiency virus (HIV) infection. High dosage intravenous antibiotics directed towards the causative microorganism were given to all of the patients. Fourteen patients underwent surgical drainage and surgical drain was positive in eleven patients (78.5%). Routine aerobic cultures were done on samples of the drained material. Bacteriology showed Streptococcus spp. the dominant microorganism in three patients, Pseudomonas spp. in one patient and no growth in ten patients. Blood culture grew Burholderia pseudomallei in one patient who responded to medical treatment. Three patients had post-operative complications but all recovered.