Cervicofacial Cellulitis of Dental Origin: Clinical and Bacteriological Features
Objectives: to describe the clinical and bacteriological profile of odontogenic cervico-facial cellulitis in a Tunisian university hospital.
Methods: This cross-sectional study was conducted on patients hospitalized for cervicofacial cellulitis of dental origin in the department of maxillofacial and plastic surgery during the period from January 2014 to December 2019. Patients hospitalized for odontogenic cervicofacial cellulitis and for whom microbiological analyses were performed, were included in the study. Data were collected from patients’ records in Sahloul Academic Hospital, Sousse, Tunisia. Identification was carried out according to the conventional bacteriological methods. Data were collected and analyzed in the SPSS 2018 (trial version).
Results: Totally, 272 patients were hospitalized for cellulitis of dental origin. Bacteriological analysis was done for only 18.3 % of them. Thirty two percent of this group were aged between 30 and 40 years old. There was a male predominance (70%). Patients were admitted mainly for circumscribed cellulitis. Only 2% of them were affected by diffuse forms. The study allowed to identify 79 strains; 49% of them were oral Streptococci and 44% were obligately anaerobes. Enterobacteria represented 5% of the isolated bacteria. Streptococcus constellatus and Streptococcus intermedius represented respectively 54% and 23% of the isolated oral Streptococci. Several antibiotics were prescribed according to the clinical conditions and/or the bacteriological analysis. Amoxicillin/clavulanic acid was the most prescribed molecule as a 1st line antibiotic. It was prescribed separately in 70% of the cases. Second-line antibiotic treatment was prescribed for 19 patients. Amoxicillin/clavulanic acid associated with another molecule was prescribed as a 2nd line antibiotherapy in 79% of the cases.
Conclusions: Management of dental origin’s cellulitis must be based on the topographic form, the associated general signs and the patient's condition. Bacteriological analyses should be done for immunosuppressed patients and/or in case of therapeutic failure in order to adjust the antibiotherapy prescription patterns.