Odontogenic Orbital Cellulitis With Deep Neck Space Abscess in a Pregnant Woman: A Rare Case and Management Challenges

ABSTRACT Background Odontogenic orbital cellulitis (OOC) is a rare but serious complication of dental infections, accounting for 2%–5% of all orbital cellulitis cases. It can be life‐threatening if not promptly diagnosed and managed, particularly in vulnerable populations such as pregnant women. This case report discusses the complex management of OOC with deep neck space involvement in a Gravida 5 para 4 female at 27 weeks of gestation—an exceptionally rare scenario with only isolated cases reported worldwide. Case Presentation A 28‐year‐old pregnant female presented with right periorbital swelling, pus discharge and signs of orbital involvement following extraction of the right maxillary and mandibular third molars. Clinical examination revealed orbital oedema, limited ocular movements and purulent discharge from the extraction site. MRI revealed multiple abscesses extending into the parapharyngeal, masseteric and orbital spaces. Surgical intervention under local anaesthesia involved incision and drainage of the buccal, retromolar and orbital abscesses, along with the placement of drains. Post‐operative care included IV antibiotics and multidisciplinary monitoring by maxillofacial and ophthalmology teams. Conclusion Odontogenic orbital cellulitis during pregnancy presents unique diagnostic and therapeutic challenges. Prompt recognition, appropriate imaging, surgical drainage, antibiotic therapy and multidisciplinary coordination are essential for favourable maternal and foetal outcomes.