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J Am Dent Assoc, Vol 130, No 7, 1086-1092. © 1999 American Dental Association

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Background. Odontogenic sinusitis is a well-recognized condition that usually is responsive to standard medical and surgical treatment. Current antibiotic therapy recommendations are directed against the usual odontogenic and sinus flora.

Case Description. The authors present a case of a patient with acute sinusitis initiated by a complicated tooth extraction that did not yield readily to standard treatment. The case was complicated by orbital extension of the sinusitis. The authors isolated methicillin-resistant Staphylococcus aureus, or MRSA, species from the affected sinus that usually is not encountered in uncomplicated acute nonnosocomial or odontogenic sinusitis.

Clinical Implications. Though such forms of resistant microbial flora as MRSA are rare, they may be seen in patients who have a history of intravenous, or IV, drug use and in immunocompromised patients. Management of patients with orbital extension of sinusitis requires hospitalization and IV antibiotic treatment.

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				P. A. Caruso, L. M. Watkins, P. Suwansaard, M. Yamamoto, M. L. Durand, L. V. Romo, S. P. Rincon, and H. D. Curtin Odontogenic Orbital Inflammation: Clinical and CT Findings--Initial Observations. Radiology, April 1, 2006; 239(1): 187 - 194. [Abstract] [Full Text] [PDF]