Systemic Inflammatory Response Syndrome and Serum Procalcitonin in Odontogenic Maxillofacial Infection

Abstract

INTRODUCTION: The systemic inflammatory response syndrome (SIRS) is a progressive, pathophysiological process which may be caused by a variety of clinical precursor events including local or generalized infection, or non-infective inflammatory process.
 АIM: To determine the development of systemic inflammatory response syndrome (SIRS) and serum procalcitonin level in patients with odontogenic infection of the maxillofacial area.
 MATERIALS AND METHODS: The prospective observational study evaluated on 158 medical patients from 2015 to 2018 at the Department of maxillofacial surgery, Faculty of Stomatology, Vitebsk state medical University. The patients were divided into 3 groups: 1 group (96 people) had acute purulent odontogenic osteomyelitis of mandible complicated by the cellulitis of one space cellular spaces, group 2 (36 patients) had acute purulent odontogenic osteomyelitis of mandible complicated by the cellulitis of 24 cellular spaces, group 3 (26 people) had acute purulent odontogenic osteomyelitis of the mandible complicated by Ludwig's angina. Blood tests of all patients were performed. Based on the blood test, breath rate, heart rate and body temperature SIRS was determined.
 RESULTS: Acute odontogenic osteomyelitis, complicated by cellulitis, is characterized by the development of SIRS. In case of one cellular space cellulitis SIRS developed in 9.0% of patients, in case of 24 cellular spaces cellulitis in 36.0%, in case of Ludwig's angina in 80.0%. PCT blood level in healthy group was 0.009 (0.0060.018) pg/ml. All patients groups had significantly higher PCT blood level compared with the healthy group: 1 group 0.034 (0.0190.050) pg/ml, U = 23, р = 0.01; 2 group 0.11 (0.060.24) pg/ml, U =12, р = 0.003; 3 group 0.41 (0.301.15) pg/ml, U = 17, р 0.001.
 CONCLUSION: Odontogenic maxillofacial infection is accompanied by SIRS. The search for significant diagnostic criteria for the development of life-threatening conditions should continue.