Advertisement
Research Article| Volume 50, ISSUE 8, P757-761, December 2012

Download started.

Ok

The clinical features of severe multi-space infections of the head and neck in patients with diabetes mellitus compared to non-diabetic patients

  • Lingyan Zheng
    Affiliations
    Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Zhizaoju Road 639, Shanghai 200011, China
    Search for articles by this author
  • Chi Yang
    Affiliations
    Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Zhizaoju Road 639, Shanghai 200011, China
    Search for articles by this author
  • Eric Kim
    Affiliations
    Maxillofacial Surgery Department of Head and Neck Surgery, Southern California Permanente Medical Group, Los Angeles, United States

    University of California, Los Angeles, United States
    Search for articles by this author
  • Weijie Zhang
    Correspondence
    Corresponding author. Tel.: +86 2123271699x5705; fax: +86 2153072423.
    Affiliations
    Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Zhizaoju Road 639, Shanghai 200011, China
    Search for articles by this author
  • Xieyi Cai
    Affiliations
    Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Zhizaoju Road 639, Shanghai 200011, China
    Search for articles by this author
  • Bin Jiang
    Affiliations
    Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Zhizaoju Road 639, Shanghai 200011, China
    Search for articles by this author
  • Baoli Wang
    Affiliations
    Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Zhizaoju Road 639, Shanghai 200011, China
    Search for articles by this author
  • Yiping Pu
    Affiliations
    Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Zhizaoju Road 639, Shanghai 200011, China
    Search for articles by this author
  • Jiamin Jin
    Affiliations
    Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Zhizaoju Road 639, Shanghai 200011, China
    Search for articles by this author
  • Jin Wang
    Affiliations
    Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Zhizaoju Road 639, Shanghai 200011, China
    Search for articles by this author
  • Zhiyuan Zhang
    Affiliations
    Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Zhizaoju Road 639, Shanghai 200011, China
    Search for articles by this author
  • Longnv Zhou
    Affiliations
    Department of Internal Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
    Search for articles by this author
  • Jian Zhou
    Affiliations
    Department of Internal Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
    Search for articles by this author
  • Xin Guan
    Affiliations
    Department of Thoracic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
    Search for articles by this author
Published:February 20, 2012DOI:https://doi.org/10.1016/j.bjoms.2012.01.019

      Abstract

      We have recorded the clinical features of diabetic patients with multispace infections of the head and neck and compared them with those of non-diabetic patients. We retrospectively studied 191 patients who were treated for severe multispace infections of the head and neck, and compared the patients’ background, the aetiology of the infection, clinical variables, laboratory values (microbiology, and blood glucose concentration, white cell count (WCC), and percentage of neutrophils on admission) and treatment (the number of incisions, complications and duration of hospital stay). Statistical analyses of the differences between groups were made with Student's t test, the chi square test, and analysis of variance, as appropriate. Diabetic patients had more spaces involved concurrently (P = 0.02), required more incisions for drainage (P = 0.002), had longer hospital stays (P < 0.0001), and developed more complications (P = 0.02). Two diabetic patients died. We conclude that diabetic patients are more likely to develop complications and the complications are more likely to be severe than those in non-diabetic patients.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to British Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Rao D.D.
        • Desai A.
        • Kulkarni R.D.
        • Gopalkrishnan K.
        • Rao C.B.
        Comparison of maxillofacial space infection in diabetic and nondiabetic patients.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 110: e7-e12
        • Leibovici L.
        • Yehezkelli Y.
        • Porter A.
        • Regev A.
        • Krauze I.
        • Harell D.
        Influence of diabetes mellitus and glycaemic control on the characteristics and outcome of common infections.
        Diabet Med. 1996; 13: 457-463
        • Delamaire M.
        • Maugendre D.
        • Moreno M.
        • Le Goff M.C.
        • Allannic H.
        • Genetet B.
        Impaired leucocyte functions in diabetic patients.
        Diabet Med. 1997; 14: 29-34
        • Alexander M.
        • Krishnan B.
        • Shenoy N.
        Diabetes mellitus and odontogenic infections—an exaggerated risk?.
        Oral Maxillofac Surg. 2008; 12: 129-130
        • Carton J.A.
        • Maradona J.A.
        • Nuño F.J.
        • Fernandez-Alvarez R.
        • Pérez-Gonzalez F.
        • Asensi V.
        Diabetes mellitus and bacteraemia: a comparative study between diabetic and non-diabetic patients.
        Eur J Med. 1992; 1: 281-287
        • Chang C.M.
        • Lu F.H.
        • Guo H.R.
        • Ko W.C.
        Klebsiella pneumoniae fascial space infections of the head and neck in Taiwan: emphasis on diabetic patients and repetitive infections.
        J Infect. 2005; 50: 34-40
        • Huang T.T.
        • Tseng F.Y.
        • Liu T.C.
        • Hsu C.J.
        • Chen Y.S.
        Deep neck infection in diabetic patients: comparison of clinical picture and outcomes with nondiabetic patients.
        Otolaryngol Head Neck Surg. 2005; 132: 943-947
        • Shah B.R.
        • Hux J.E.
        Quantifying the risk of infectious diseases for people with diabetes.
        Diabetes Care. 2003; 26: 510-513
        • Huang T.T.
        • Tseng F.Y.
        • Yeh T.H.
        • Hsu C.J.
        • Chen Y.S.
        Factors affecting the bacteriology of deep neck infection: a retrospective study of 128 patients.
        Acta Otolaryngol. 2006; 126: 396-401
        • Lee J.K.
        • Kim H.D.
        • Lim S.C.
        Predisposing factors of complicated deep neck infection: an analysis of 158 cases.
        Yonsei Med J. 2007; 48: 55-62
        • Infante-Cossío P.
        • Fernández-Hinojosa E.
        • Mangas-Cruz M.A.
        • González-Pérez L.M.
        Ludwig's angina and ketoacidosis as a first manifestation of diabetes mellitus.
        Med Oral Patol Oral Cir Bucal. 2010; 15: 624-627
        • Nakamura S.
        • Inui M.
        • Nakase M.
        • Kamei T.
        • Higuchi Y.
        • Goto A.
        • et al.
        Clostridial deep neck infection developed after extraction of a tooth: a case report and review of the literature in Japan.
        Oral Dis. 2002; 8: 224-226
        • Chandu A.
        • Macisaac R.J.
        • Smith A.C.
        • Bach L.A.
        Diabetic ketoacidosis secondary to dento-alveolar infection.
        Int J Oral Maxillofac Surg. 2002; 31: 57-59
        • Martín-Moro J.G.
        • Calleja J.M.
        • García M.B.
        • Carretero J.L.
        • Rodríguez J.G.
        Rhino-orbitocerebral mucormycosis: a case report and literature review.
        Med Oral Patol Oral Cir Bucal. 2008; 13: E792-E795
        • Yamagata K.
        • Takeda M.
        • Onizawa K.
        • Yoshida H.
        Submandibular abscess caused by Salmonella.
        Int J Oral Maxillofac Surg. 2006; 35: 969-971
        • Bross-Soriano D.
        • Arrieta-Gómez J.R.
        • Prado-Calleros H.
        • Schimelmitz-Idi J.
        • Jorba-Basave S.
        Management of Ludwig's angina with small neck incisions: 18 years experience.
        Otolaryngol Head Neck Surg. 2004; 130: 712-717
        • Chen M.K.
        • Wen Y.S.
        • Chang C.C.
        • Lee H.S.
        • Huang M.T.
        • Hsiao H.C.
        Deep neck infections in diabetic patients.
        Am J Otolaryngol. 2000; 21: 169-173
        • Rega A.J.
        • Aziz S.R.
        • Ziccardi V.B.
        Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin.
        J Oral Maxillofac Surg. 2006; 64: 1377-1380
        • Al-Qamachi L.H.
        • Aga H.
        • McMahon J.
        • Leanord A.
        • Hammersley N.
        Microbiology of odontogenic infections in deep neck spaces: a retrospective study.
        Br J Oral Maxillofac Surg. 2010; 48: 37-39
        • Levetan C.S.
        • Magee M.F.
        Hospital management of diabetes.
        Endocrinol Metab Clin North Am. 2000; 29: 745-770
        • Hasegawa J.
        • Hidaka H.
        • Tateda M.
        • Kudo T.
        • Sagai S.
        • Miyazaki M.
        • et al.
        An analysis of clinical risk factors of deep neck infection.
        Auris Nasus Larynx. 2011; 38: 101-107
        • Iwata T.
        • Sekine Y.
        • Shibuya K.
        • Yasufuku K.
        • Iyoda A.
        • Iizasa T.
        • et al.
        Early open thoracotomy and mediastinopleural irrigation for severe descending necrotizing mediastinitis.
        Eur J Cardiothorac Surg. 2005; 28: 384-388
        • Roccia F.
        • Pecorari G.C.
        • Oliaro A.
        • Passet E.
        • Rossi P.
        • Nadalin J.
        • et al.
        Ten years of descending necrotizing mediastinitis: management of 23 cases.
        J Oral Maxillofac Surg. 2007; 65: 1716-1724
        • Huang T.T.
        • Liu T.C.
        • Chen P.R.
        • Tseng F.Y.
        • Yeh T.H.
        • Chen Y.S.
        Deep neck infection: analysis of 185 cases.
        Head Neck. 2004; 26: 854-860