Abstract
Acute bacterial cervicofacial infection is a common problem that is most often secondary
to dental infection. Most cases present as localised abscesses but some may be associated
with serious morbidity including scarring, embarrassment of the airway, SIRS (systemic
inflammatory response syndrome), and sepsis syndrome. Fourteen oral surgery or maxillofacial
surgery units in Scotland took part in a clinical audit of acute infection during
two four-week cycles (August and November) in 2010. Information regarding the patients,
signs and symptoms, and management was recorded. Training material was distributed
between cycles with information on SIRS, sepsis, and the prescription of antibiotics.
Overall, 140 patients presented with acute infection. There was an equal sex distribution
and ages ranged from 5 to 87 years. There was an association with deprivation and
36% of patients were from the lowest socioeconomic quintile. Most infections were
dental (n = 120, 86%), and patients presented with pain and swelling (n = 120, 86% and n = 134, 96%, respectively) Twenty-three patients (16%) met the criteria for SIRS. A further
23 (16%) had at least one positive SIRS marker with incomplete recording of the remaining
markers. Twenty-six patients (19%) had no recorded SIRS markers. Cervicofacial infection
can be associated with serious morbidity and mortality, which may be better managed
if the systemic signs and symptoms of sepsis are recognised and recorded at presentation.
This study showed that the recording of signs of sepsis was variable even with training.
Further training of junior staff to recognise severe acute bacterial infection may
improve management.
Keywords
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Article info
Publication history
Published online: December 29, 2011
Accepted:
November 25,
2011
Identification
Copyright
© 2011 Published by Elsevier Inc.
