Acute pulpal-alveolar cellulitis syndrome. III. Endodontic therapeutic factors and the resolution of a Candida albicans infection.

An acute pulpal-alveolar cellulitis, involving a drug-resistant Candida albicans, was resolved successfully with endodontic treatment in 6 days. Effective debridement, irrigation, and intracanal medication were significant factors in obtaining a negative culture at completion of treatment. The case illustrates that clinical procedures and judgment can be major factors in the resolution of serious infection, where antibiotic therapy is not feasible. External heat compresses should be avoided in pulpal-alveolar cellulitis cases. Hot intraoral saline rinses are recommended to promote tooth drainage and the formation of fluctuant mucosal swellings. External cold compresses may help reduce facial swelling and provide relief from discomfort.