title: Spread of odontogenic infections in Port Harcourt, Nigeria.
abstract: OBJECTIVE
  Odontogenic infections constitute a substantial portion of diseases encountered by oral and maxillofacial surgeons. Infections start from dental tissues and sometimes rapidly spread to contiguous spaces. The consequence is a fulminant disease with significant morbidity and mortality. The study was aimed at studying the pattern of spread, approach to management, and outcome of these infections at a Nigerian teaching hospital.
  
  
  METHODS
  A retrospective study of all patients with orofacial infections who presented to our center over an 18-month period was carried out. The medical records were reviewed to retrieve the following: age, gender, source of infection, anatomic fascial spaces involved, associated medical conditions, various treatment modalities, types of antibiotics administered, causative micro-organisms, length of stay in the hospital, and any complications encountered. Infections were classified into 2 categories: those that are confined to the dentoalveolar tissues belong to category I, and those that have spread into the local/regional soft tissue spaces and beyond belong to category II.
  
  
  RESULTS
  Odontogenic infections constituted 11.3% of the total oral and maxillofacial surgery cases. A total of 261 patients were treated for odontogenic infections. There were 146 female patients (59.8%) and 98 male patients (40.2%) in the first category, whereas the second category comprised 10 male patients (58.8%) and 7 female patients (41.2%). The fascial spaces involved, in descending order, were submasseteric in 10 (22.7%), submandibular in 9 (20.5%), and sublingual in 6 (13.6%). The causative micro-organisms commonly found were Klebsiella and Streptococcus spp. Incision and drainage were performed in the 17 cases with spreading infection. Amoxicillin, amoxicillin/clavulanate, and metronidazole were the most routinely administered antibiotics.
  
  
  CONCLUSIONS
  Our experience shows that delay in presentation, self-medication, aging, male gender, and unusual causative agents are some of the factors associated with spread. Therefore efforts must be made to further improve public dental awareness.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. akinbamzy3@yahoo.com
authors.forename: Babatunde Olayemi
authors.initials: BO
authors.lastname: Akinbami
authors.forename: Oladimeji
authors.initials: O
authors.lastname: Akadiri
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Gbujie
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000473:pathology / Q000628:therapy; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D005491:Focal Infection, Dental / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007223:Infant; D007710:Klebsiella Infections / Q000188:drug therapy / Q000473:pathology; D008158:Ludwig's Angina / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D010482:Periapical Abscess / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D010497:Pericoronitis / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D010508:Periodontal Abscess / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D011446:Prospective Studies; D011512:Proteus Infections / Q000188:drug therapy / Q000473:pathology; D012189:Retrospective Studies; D012737:Sex Factors; D014081:Tooth Extraction; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents