- 期刊
口腔帶狀皰疹病毒感染－病例報告
Oral Herpes Zoster Infection-Case Report
摘要
患者因右下眼眶區及上唇右側發生腫脹與疼痛而至本院急診。急診前，於診所接受右下第一大臼齒根管治療後，感覺前述區域逐浙腫脹，隔日急診。影像檢查並無疑似齒源性感染，口內發現右上犬齒頰側前庭區腫脹，硬腭右半區有白色斑點突起潰瘍。因患者感覺脹痛，於急診時接受右側犬齒間隙切開減壓後，開立抗生素及止痛劑。患者回診時症狀稍緩解，但右臉部三叉神經V1及V2區域發生帶狀紅疹，轉診至皮膚科後經Tzanck smear證實爲帶狀皰疹病毒感染，並安排住院接受感染控制，一週後症狀幾近消失後出院，一個月後回診已康復，唯仍有部分異常感覺之情況。帶狀皰疹之臨床徵兆有牙痛、口內黏膜水泡潰瘍、皮膚帶狀紅疹，甚至顎骨壞死，爲每一位口腔顎面外科醫師均可能過見的疾病，對此疾病應有完整認知，以免延遲治療。
並列摘要
This 42 years old male visited at Emergency Service due to the swelling over the right side infraorbital area and the upper lip after endodontic treatment of the right first molar at local dental clinic. Under examination, moderate swelling over the vestibular area of the right upper canine and multiple vesicles and ulcers over the right palate were noted. Panoramic x-rays showed no evidence of the odontogenic infection. The patient felt fullness and pain over the vestibular area, so we performed incision and drainage at canine space to decrease pressure, and prescribed antibiotics and analgesics at Emergency Service. He found the improvement of the symptoms and signs two days after first-aid, but skin rash existed over the 1(superscript st) and 2(superscript nd) branch of the fifth cranial nerve. We referred the patient to dermatology, Tzanck smear proved herpes zoster infection, and arranged admission. The symptom disappeared nearly one week after admission. Symptoms except parathesia were cured.Toothache, oral mucous vesicles and ulcers, skin rash and necrosis of jaw bone are clinical signs of herpes zoster infection. The symptoms of herpes zoster infection over oral cavity may be easily confused with the common odontogenic infection by the oral surgeon. We present this rare case for differential diagnosis with another odontogenic infection condition to prevent from delaying treatment.