Multidisciplinary Staged Management of a Complex Zygomatico-Buccal Abscess in a Diabetic High-Risk Gravida: A Case Report

Severe soft tissue infections (SSTIs) in pregnancy are rare yet life-threatening, particularly when exacerbated by diabetes-induced immune dysfunction and impaired wound healing. We report a 35-year-old multigravida (G4P2A1) at 31 weeks’ gestation presenting with a rapidly progressing zygomatico-buccal abscess, poorly controlled type 2 diabetes, and a history of recurrent fetal loss. Admission findings confirmed systemic infection, severe metabolic derangement, and threatened preterm labor. A prioritized clinical protocol was implemented: initial management focused on metabolic stabilization through intensive glycemic control and obstetric optimization via tocolysis and antenatal corticosteroids. Following stabilization, surgical debridement and culture-guided antimicrobial therapy were performed, followed by phase-adapted wound care. This integrated approach achieved favorable maternal and fetal outcomes, emphasizing that successful management of complex SSTIs in high-risk pregnancies necessitates a carefully timed, collaborative strategy rather than isolated interventions.