Demographic and clinical characteristics of patients presenting with Cervico-Facial Cellulitis at the University of Calabar Teaching Hospital, Nigeria.

Abstract

Background/Objective: The study is aimed at evaluating the demographic and clinical characteristics of patients who presented with infections involving the cervico-facial region in a Nigerian tertiary hospital Patients and Methods: All patients that were managed for cervico-facial infections, over a 4-year period, at the Oral and Maxillofacial Unit of the University of Calabar Teaching Hospital, Calabar, Nigeria were retrospectively studied. The information obtained were the demographics, duration of symptoms, month of the year, source of infection, fascia space(s) involved, whether managed on in or out-patient basis, duration of hospital stay where applicable, treatment done, complications and treatment outcome. The information was analyzed using the statistical package for social sciences (SPSS version 13, Illinois, Chicago). P<0.05 was considered significant. Results: A total of 36 cases comprising 19 males and 17 females were seen, giving a male-to-female ratio of 1.2:1. The ages ranged from 2 -73 years, mean 40.6 ±17.12 years. Patients aged 21 and above were mostly affected and the most commonly affected age was the 51-60 years (n=9; 25%) age group. This was followed by the 21-30 years and the 31-40 years age brackets each equally represented by 7 (19.4%) cases. Distribution of cases was bimodal, with the first peak at January and February and second peak at June. This monthly distribution was significant (Fisher’s Exact test: ×2= 29.487; P=0.001). The buccal space was the most commonly affected accounting for 14 (38.9%), and this was followed by bilateral sublingual, submandibular and submental spaces (Ludwig’sangina) with observed frequency of 6 (16.7%). The source of infection was mainly of dental origin (n=34; 94.4% with non-odontogenic sources accounting for only 2 (5.6%) cases. Those of odontogenic origin was mainly due to infections involving lower molars (n=17; 50%). The length of hospital stay ranged from 2-21 days, mean (SD), 7.8 (4.9) days. Two out of the 36 patients died, giving a mortality of 5.6%. Involvement of distant sites outside the cervico-facial region (OR=1.67; P=0.016), time interval between onset and presentation to the Oral and Maxillofacial Unit (OR=1.33; P=0.044), as well as age of patients (OR=3.00; P=0.005) were found to significantly contribute to survival of patients. Conclusion: Buccal space was most commonly involved site which is different from most previous reports from Nigeria. Late presentation to the Oral and Maxillofacial Surgeon, advanced age and distant spread were the contributory factors to poor prognosis.