Ultrasonographic evaluation of superficial space infections

Abstract

Aims and Objectives: To evaluate the use of ultrasonography as a diagnostic tool in determining the state of infection, i.e., cellulitis or abscess, in the superficial space infection of odontogenic origin. Materials and Methods: A total of 35 patients visiting the department and having an inflammatory swelling of odontogenic origin were chosen. Thorough history and clinical examination of patients was done to reach a clinical diagnosis of cellulitis or abscess. Ultrasonography was performed with the help of transducing gel using a linear probe to determine the state of infection, i.e., cellulitis or abscess. Results: Out of 35 patients, 19 patients were clinically diagnosed as abscess whereas the remaining 16 patients were clinically diagnosed as cellulitis. For the 19 patients who were clinically diagnosed as abscess, ultrasonography revealed focal accumulation of fluid suggestive of abscess cavity in all the 19 cases, and ultrasound-guided aspiration was positive in all the cases. For the 16 patients who were clinically diagnosed as cellulitis, ultrasonography revealed focal areas of fluid accumulation suggestive of abscess formation in 5 cases, and ultrasound-guided aspiration was positive all these 5 cases. Sensitivity (100%) and negative predictive value (100%) of ultrasound is much better than that of clinical diagnosis, which is 79% and 69%, respectively, in the detection of state of infection. Conclusion: Ultrasonography was found to be a valuable adjunct to clinical diagnosis in determining the state of infection, i.e., cellulitis or abscess.