PATTERN OF OROFACIAL BACTERIAL INFECTIONS IN A TERTIARY HOSPITAL IN SOUTHWEST, NIGERIA

Orofacial bacterial infections present in diverse patterns due to the anatomical complexity of the area. The likelihood of spread from the initial area of infection is also high because of the presence of contiguous spaces in the head and neck region.

To determine the pattern and management outcome of orofacial bacterial infections in Southwest Nigeria.

A prospective study.

University College Hospital, Ibadan, Nigeria.

A prospective study on 102 patients with orofacial bacterial infections seen between June and December, 2011 was carried out. The information collected with data sheet included socio- demographic data, clinical history and examination, treatment and outcome. Frequencies, means, medians and diagrams of relevant variable generated. Chi square test was used to test association between categorical variables at p<0.05.

Male to female ratio was 1.1: 1 with age range 10 months to 83 years and mean age 33.0 (±20.3) years. The median number of days between onset of orofacial bacterial infection and presentation for treatment was 7 (range 3-90) days. Sixty seven (65.7%) patients presented to hospital within 7 days of the onset of symptoms of infection. Pain was the common symptom 100 (98.04%), followed by sleep disturbance 71 (69.6%) while the least common symptom was dyspnea 18 (17.7%). Most of the early presenters had complaint of sleep disturbance (67.6%) while most of the late presenters had dyspnea (44.4%). Positive medical history including diabetes mellitus was reported by 28 patients (27.6%). Sixty seven (65.7%) had fascial space involvement, of which the majority 38 (56.7%) had multiple space involvement. Eight (21%) of those with multiple space involvement had submental, bilateral sublingual and submandibular spaces (Ludwig's angina).The majority 12 (41.4%) of those with single space infection had it in submandibular space. The majority 35 (45%) of the patients with odontogenic infections had it in right posterior mandible. All the patients had antibiotics prescribed for them and also had one form of surgical treatment or the other which included extraction, incision and draina cge with extraction, decompression, exploration and debridement and sequestrectomy. The majority (90.5%) of the participants whose orofacial bacterial infection resulted into swelling had regression of the swelling and majority (90.0%) of those who had inadequate mouth opening had adequate mouth opening after treatment. Three mortalities were recorded in the course of the study.

Odontogenic aetiology is commoner than non odontogenic. Multiple fascial space involvement occurred more than single space. Outcome was good with adequate treatment although few cases of mortalities were recorded.