Spread of odontogenic infections in Port Harcourt, Nigeria.
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.
Akinbami
Babatunde Olayemi
BO
Department of Oral and Maxillofacial Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. akinbamzy3@yahoo.com
Akadiri
Oladimeji
O
Gbujie
Daniel C
DC
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
D000900:Anti-Bacterial Agents