Infected orthokeratinized odontogenic cyst: a rare cause of facial cellulitis.

Oct 2012

Carvalho CH, Aquino AR, Nonaka CF, Silva JS, Germano Ada R, Pinto LP.

Source

Department of Oral Pathology, Dental School, Federal University of Rio Grande do Norte, Natal, RN, Brazil.

Abstract

Orthokeratinized odontogenic cysts (OOCs) are relatively uncommon developmental cysts lined with orthokeratinized epithelium consisting of a prominent granular layer and a basal layer of low cuboidal flattened cells that show no tendency for nuclear palisading. These cysts have been considered a distinct entity from odontogenic keratocysts since they exhibit a less aggressive behavior and a very low rate of recurrence. Developmental odontogenic cysts can become infected but serious complications, such as potentially life-threatening cellulitis, are rare. This report describes a rare case of facia lcellulitis secondary to an infected OOC located in the mandible of a 27-year-old man. The relevant literature about the clinical-pathological features of OOC is reviewed.

PubMed

Burden of facial cellulitis: estimates from the Nationwide Emergency Department Sample.

Sept 2012

Kim MK, Allareddy V, Nalliah RP, Kim JE, Allareddy V.

Source

DMD student, Harvard School of Dental Medicine, Boston, MA.

Abstract

OBJECTIVE:

Multitude of maxillofacial infections from odontogenic and nonodontogenic origins can progress to facialcellulitis, which may require an emergency department (ED) visit for appropriate care. The aim of this study was to investigate national prevalence of ED visits attributed primarily to facial cellulitis, to quantify the associated hospital charges, and to identify a cohort of population presenting to the ED with facial cellulitis.

STUDY DESIGN:

The Nationwide Emergency Department Sample (NEDS) for the year 2007, a component database of the health care cost and utilization project was used for this study. All ED visits that had a primary diagnosis of facial cellulitis(ICD-9-CM code 682.0) were selected for analysis. All estimates were projected to national levels using the discharge weight variables.

RESULTS:

In 2007, a total of 302,507 ED visits were attributed primarily to facial cellulitis in the USA. The average age of the patients was 35.0 years. The mean hospital charge for each ED visit was $1,024, with a total charge of $241,541,694. A total of 17.8% of ED visits were admitted into the same hospital for inpatient care, and 78.5% of ED visits were discharged routinely; 67.6% of ED visits occurred on weekdays. Private insurance payers comprised the largest proportion (31.6%).

CONCLUSIONS:

This study highlights the prevalence of hospital-based ED visits primarily due to facial cellulitis in the USA in year 2007, its significant associated hospital resource utilization for treatment, and characteristics of the patient population who are likely to visit a hospital-based ED for treatment of facial cellulitis.

Science Direct

Diffuse cervico-facial cellulitis: 32 cases in Libreville.

July 2011

Miloundja J, Assini Eyogho SF, Mandji Lawson JM, Ondounda M, Koumba JS, Lekassa P, Inibend M, N'zouba L.

Source

Hôpital d'instruction des armées Omar Bongo Ondimba Service d'ORL&CCF Libreville Gabon.

Abstract

Objective: The aim of this study was to analyze the predisposing factors and the diagnostic and therapeutic aspects of diffuse cervico-facial cellulitis.

Material and methods: This retrospective study examined the records of all 32 patients admitted to the ENT and cervico-facial department of the Omar Bongo Ondimba Army Teaching Hospital in Libreville with diffuse cervico-facial cellulitis, from January 2006 through December 2010.

Results: The study included 18 women (56%) and 14 men (44%) with a mean age of 28 years. At admission, 28 patients (87.5%) had already received anti-inflammatory drugs and 25 (78%) one or more antibiotics. Two patients were HIV+. The main route was dental for 21 patients (66%), tonsillar for 4 (13%), submandibular for 2 (6%), parotid for 2 cases (6%), cutaneous for 1 (3%) and unspecified in 2 more (6%). The cellulitis was pseudo-phlegmonous in 24 patients (75%) and gangrenous in 8 cases (25%). It extended to the mediastinum in six patients (19%). The bacteriological study, carried out in 24 cases (75%), found 14 cases of aerobic germs. Medical or medical and surgical treatment led to cure for 30 patients (94%). Two patients (6%) died.

Conclusion: Treatment of cervico-facial cellulitis must be early and multidisciplinary. Self-medication with anti-inflammatory drugs for bucco-pharyngeal infections without appropriate antibiotic treatment is the principal predisposing factor.

John Libbey Eurotext

Clindamycin versus Unasyn in the treatment of facial cellulitis of odontogenic origin in children.

Clindamycin versus Unasyn in the treatment of facial cellulitis of odontogenic origin in children.

Rush DE,
Abdel-Haq N, Zhu JF, Aamar B, Malian M.

Children's Hospital of Michigan and Wayne State University, Detroit, Michigan, USA.

The study was undertaken to characterize the microbiology of dental abscesses in children and to compare clindamycin and ampicillin/sulbactam in the treatment of facial cellulitis of odontogenic origin. Sixty children with acute facial cellulitis of dental origin underwent surgery (extraction or root canal procedure) within 24 hours of presentation. Pus samples were cultured aerobically and anaerobically. Patients were randomized (1:1) to receive intravenous ampicillin/sulbactam or clindamycin for 48 hours followed by oral amoxicillin/clavulanate or clindamycin for 7 days.

A total of 211 bacterial isolates were recovered from 54 samples. The most common aerobic and facultative organisms were viridans streptococci, Neisseria, and Eikenella species. Among anaerobes, Prevotella and Peptostreptococcus species were the most frequent. No treatment failure occurred in either group.

Dental abscesses in children are polymicrobial aerobic/anaerobic infections. Treatment of complicated dental infections with ampicillin plus a beta-lactamase inhibitor or clindamycinin combination with surgical drainage is very effective.

Key Words: clindamycin • Unasyn • dental • cellulitis • abscess • children

Sage Publications