Infratemporal abscess: a rare complication of a common procedure
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The infratemporal fossa (ITF) is an anatomically complex cavity that houses a variety of muscular and neurovascular structures at the base of the skull. Infections involving the ITF, though uncommon, can be fatal due to the difficulties of accessing this anatomical space and its proclivity to evolve into a cavernous venous thrombosis (CVT). As a result, a multi-disciplinary approach involving several surgical and medical subspecialists is often warranted. We present a case of an infratemporal fossa abscess (IFA) after wisdom teeth extraction with a very complicated clinical course and a distinct microbiologic profile.
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Comments to Author
Changes carried out satisfactory.
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Partially support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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Comments to Author
Many thanks for taking the reviewer comments into consideration and for the changes made. The added figure for the case report timeline certainly makes the clinical course easier to follow.
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Comments to Author
Many thanks for taking the reviewer comments into consideration and for the changes made. The added figure for the case report timeline certainly makes the clinical course easier to follow.
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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The reviewers have highlighted minor concerns with the work presented. Please ensure that you address their comments.
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Comments to Author
This case report describes an infratemporal fossa abscess following wisdom tooth extraction and the clinical course for diagnosis. To the authors knowledge, this is the first reported case of this type of abscess caused by E. corrodens and S. anginosus. 1. Description of the case(s) Detailed clinical description with adequate use of patient vitals Following queries: Line 85: I would be interested to know what were the symptoms experienced which suspected sialadenitis and how this led to the first prescription of antibiotics? Line 83: It may be helpful to give further details on which wisdom teeth were extracted (e.g. upper/lower/both)? 2. Presentation of results Good use of figures to demonstrate size of infection present visually Line 125: Please use a non-commercial name for Peridex mouthwash.
Comments to Author
This case report describes an infratemporal fossa abscess following wisdom tooth extraction and the clinical course for diagnosis. To the authors knowledge, this is the first reported case of this type of abscess caused by E. corrodens and S. anginosus. 1. Description of the case(s) Detailed clinical description with adequate use of patient vitals Following queries: Line 85: I would be interested to know what were the symptoms experienced which suspected sialadenitis and how this led to the first prescription of antibiotics? Line 83: It may be helpful to give further details on which wisdom teeth were extracted (e.g. upper/lower/both)? 2. Presentation of results Good use of figures to demonstrate size of infection present visually Line 125: Please use a non-commercial name for Peridex mouthwash. It may be helpful to also provide a table which shows the appointments/visits and the summary of investigations or treatment provided. 3. How the style and organization of the paper communicates and represents key findings Follows the clinical story, please see above for a potential addition to help reader visualise the timeline better. 4. Literature analysis or discussion Good examples of previous systematic reviews and literature available to date with direct comparison to current case Good overview of bacteria involved Query: I would also like to see what could have been done differently to come to the diagnosis faster? 5. Any other relevant comments Please kindly change the following: Punctuation on Line 68 ".." You may want to add a reference to Line 67-70 There are some spelling changes which you may want to change Line 70 "levator veli palatini" Line 87 "laboratory" Line 179-180 please kindly italicise bacterial names
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Partially support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
-
Comments to Author
The clinical case described involves a 20 year old male with a presentation of an infratemporal abscess with intra-operative cultures of S. anginosus and E. corrodens. 1. Description of the case(s) A. The report contains an in depth description of the infratemporal region and its intricacies. B. The case is well presented but a timeline figure of presentation, investigation and treatment would aid summarising the case. I would also suggest including further details behind treatment decisions. Eg. Were any local guidelines/SOPs followed? Are cephalosporins the first line of treatment for suspected sialadenitis? Why was sialadenitis suspected during the first presentation? C. I would also recommend including details of the drug class when medications are mentioned in the report eg. "Cephalexin for …
Comments to Author
The clinical case described involves a 20 year old male with a presentation of an infratemporal abscess with intra-operative cultures of S. anginosus and E. corrodens. 1. Description of the case(s) A. The report contains an in depth description of the infratemporal region and its intricacies. B. The case is well presented but a timeline figure of presentation, investigation and treatment would aid summarising the case. I would also suggest including further details behind treatment decisions. Eg. Were any local guidelines/SOPs followed? Are cephalosporins the first line of treatment for suspected sialadenitis? Why was sialadenitis suspected during the first presentation? C. I would also recommend including details of the drug class when medications are mentioned in the report eg. "Cephalexin for suspected sialadenitis", "oxycodone and acetaminophen for analgesia" and to avoid using brand names eg. "Peridex". This will aid non-US readers' understanding of which medications were prescribed especially when the brand is not available or commercialised under a different name outside of the US. 2. Presentation of results and 3. How the style and organization of the paper communicates and represents key findings Refer to point 1B. A figure with a timeline of findings and treatment would be useful B. Would the authors further elaborate on how they came to the conclusion that a third molar extraction was the source of the infratemporal infection? Had any other sources been ruled out, if so how? Have the microorganisms isolated from the infratemporal fossa been identified in the patient's oral cavity? 4. Literature analysis or discussion Kindly add a few sentences in the discussion on any known virulence factors of S. anginosus and E. corrodens and possible mechanisms through which these microorganisms can lead to infratemporal invasion. 5. Other: A sentence on the limitations of the conclusions and what additional tests would have confirmed the true origin of S. anginosus and E. corrodens would enhance the conclusions of this work
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Partially support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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