Manejo terapéutico de la celulitis crónica circunscrita: a propósito de un caso clínico

espanolLa celulitis cronica circunscrita es resultado de la persistencia de una lesion dentaria, bacterias de baja virulencia o una antibioterapia mal planteada. Se caracteriza por la presencia de un cordon fibroso, signo patognomonico, que debe ser eliminado junto al foco causal. La clinica es poco llamativa y puede pasar desapercibida al paciente. Sin embargo, no esta exenta de un posible proceso de agudizacion que dificulten su posterior tratamiento o que actuen como un foco infeccioso a distancia. Se presenta un caso de un paciente de 51 anos que acude a consulta exudado de contenido purulento a traves de una fistula extra oral de un ano de evolucion. Se realizo la extraccion de los dientes involucrados y se elimino el cordon fibroso asociado. Se plantea junto al abordaje quirurgico una pauta antibiotica de corta duracion para prevenir la aparicion de resistencias basado en la evidencia cientifica actual. EnglishCircumscribed chronic cellulitis is the result of the persistence of a dental lesion, bacteria of low virulence or poorly raised antibiotic therapy. It has been defined by the presence of a fibrous cord, a pathognomonic sign, which must be eliminated together with the causal focus. The clinic is inconspicuous and can go unnoticed to the patient. However, it is not exempt from a possible process of exacerbation that hinders its subsequent treatment or that acts as an infectious focus at a distance. We present a case of a 51-year-old patient who included an exudate consultation of purulent content through an extra oral fistula that had been one year old. The extraction of the involved teeth was performed and the associated fibrous cord was removed. It is presented with the surgical approach, a short-term medical practice to prevent the emergence of resistance based on current scientific evidence.