title: Cervicofacial cellulitis: The impact of non-steroidal anti-inflammatory drugs. A study of 70 cases.
abstract: BACKGROUND
  Cervicofacial cellulitis (CFC) is a severe infection of the subcutaneous cellular tissue, and is one of the most serious head and neck infectious emergencies. In a series of 70 cases treated between 2007 and 2012, we noticed a strong correlation between use of non-steroidal anti-inflammatory drugs (NSAIDs) and evolution of head and neck infections toward CFC, including two cases of necrotic CFC extending to the mediastinum, which were fatal.
  
  
  METHODS
  The cases included in the series comprised patients admitted to emergency and requiring hospitalization due to the severity of presenting symptoms. There were 70 such cases of CFC between 2007 and 2012; cases managed on an outpatient basis were excluded, as were cases of orbital CFC, CFC of sinus origin and mastoiditis.
  
  
  RESULTS
  Eighty percent of patients took NSAIDs, on self-medication or by prescription (community physician, dentist, pharmacist). The most frequent molecules were tiaprofenic acid and diclofenac. CFC extension was restricted in most cases to the maxillary and/or ipsilateral subhyoid region, with 5 cases of lower cervical extension and 2 of mediastinal involvement, which both proved fatal.
  
  
  CONCLUSIONS
  CFC is a severe infection that can be life-threatening, and represents a diagnostic and therapeutic emergency. Among other risk factors, use of NSAIDs is frequently reported; these should therefore be used with caution if at all in head and neck infection, especially of odonto-stomatological origin.
authors.affiliation: Service d'oto-rhino-laryngologie et chirurgie cervico-faciale, faculté de médecine et de pharmacie, hôpital des spécialités Rabat, 10000 Rabat, Morocco. Electronic address: dr.a.bennani@gmail.com.
authors.forename: A A
authors.initials: AA
authors.lastname: Bennani-Baïti
authors.affiliation: Service d'oto-rhino-laryngologie et chirurgie cervico-faciale, faculté de médecine et de pharmacie, hôpital des spécialités Rabat, 10000 Rabat, Morocco.
authors.forename: A
authors.initials: A
authors.lastname: Benbouzid
authors.affiliation: Service d'oto-rhino-laryngologie et chirurgie cervico-faciale, faculté de médecine et de pharmacie, hôpital des spécialités Rabat, 10000 Rabat, Morocco; UFR d'ORL et de CMF, faculté de médecine et de pharmacie, université Mohmamed V, Rabat, Morocco.
authors.forename: L
authors.initials: L
authors.lastname: Essakalli-Hossyni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D002481:Cellulitis / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D004322:Drainage; D005260:Female; D006257:Head; D006801:Humans; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D009333:Neck; D009336:Necrosis; D011446:Prospective Studies; D012307:Risk Factors; D007507:Therapeutic Irrigation; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Cervicofacial cellulitis; Non-steroidal anti-inflammatory drugs