title: Isolation of Staphylococcus aureus and black-pigmented bacteroides indicate a high risk for the development of Ludwig's angina.
abstract: OBJECTIVE
  The aim of this study was to compare clinical, microbiological, enzymatic, and host immune response variables between subjects hospitalized with facial cellulitis, with Ludwig's angina (LA) and without Ludwig's angina (WOLA).
  
  
  METHODS
  Microbiological and enzymatic tests on pus, and hematological and immunological assessments on blood samples of 15 patients with LA and 42 patients with WOLA were performed. Laboratory findings of both groups were compared using the Student t test. Multiple logistic regression analysis was performed and significant differences identified by univariate analysis.
  
  
  RESULTS
  Patients with LA demonstrated increased levels of white blood cell counts, urea, and CRP levels, and decreased levels of CIC compared with patients WOLA. However, only CRP and urea were found to be significantly raised in the LA group. A greater population of Staphylococcus aureus and black-pigmented bacteroides were isolated from patients with LA.
  
  
  CONCLUSIONS
  Elevated levels of CRP and urea could indicate the severity of infection in patients with LA. This could be because of the highly virulent and fast-spreading organisms, S. aureus and black-pigmented bacteroides, which may be a factor indicative of LA.
authors.affiliation: Division of Oral Microbiology, Department of Clinical Microbiology, National Health Laboratory Services, Faculty of Health Sciences, University of the Witwatersrand, Gauteng, South Africa.
authors.forename: Mrudula
authors.initials: M
authors.lastname: Patel
authors.forename: Thoganthiren Perumal
authors.initials: TP
authors.lastname: Chettiar
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Wadee
mesh_terms: D000293:Adolescent; D000328:Adult; D001439:Bacteroides / Q000302:isolation & purification; D001442:Bacteroides Infections / Q000150:complications*; D002097:C-Reactive Protein / Q000032:analysis; D002481:Cellulitis / Q000150:complications / Q000382:microbiology; D015169:Colony Count, Microbial; D005260:Female; D005491:Focal Infection, Dental / Q000097:blood / Q000150:complications* / Q000382:microbiology; D006801:Humans; D016015:Logistic Models; D008158:Ludwig's Angina / Q000097:blood / Q000209:etiology* / Q000276:immunology / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000382:microbiology; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000150:complications*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013492:Suppuration / Q000201:enzymology / Q000382:microbiology; D014508:Urea / Q000097:blood; D055815:Young Adult
chemical_list: D014508:Urea; D002097:C-Reactive Protein