A Case of Acute Cholecystitis and Sepsis with Severe Symptoms during Treatment of Buccal Cellulitis

We report a rare case of acute cholecystitis and sepsis diagnosed during the treatment of left-sided buccal cellulitis. A 67-year-old man visited a nearby hospital because of worsening swelling and pain on the left side of his face and was admitted to a hospital for anti-inflammatory treatment. However, his symptoms did not improve, and he was referred to our hospital for treatment. We diagnosed the cause of the left buccal cellulitis as marginal periodontitis of the maxillary left first and second molars. After receiving anti-inflammatory treatment with antimicrobial agents and undergoing tooth extraction, the patient’s clinical findings indicated resolution of the inflammation; however, blood tests did not show any improvement in C-reactive protein levels. This led to a suspicion of inflammation in other organs; hence, the patient was referred to the gastroenterology department. Echocardiography and other tests revealed acute cholecystitis. The patient’s general condition then deteriorated rapidly, and he developed septic shock. First aid and anti-inflammatory treatment were administered, following which the patient’s general condition improved.