Face Of Infection Research Articles

Facial cutaneous tuberculosis infected by non-tuberculous mycobacteria

BackgroundCutaneous infections caused by non-tuberculous mycobacteria (NTM) are extremely rare, particularly when they are localized to the facial area. This condition presents significant diagnostic challenges due to its unusual presentation and the need for precise microbiological identification.Case PresentationA two-year-old male patient presented with a progressively enlarging reddish-brown mass on the left side of his face. Despite the absence of systemic symptoms, the lesion’s growth warranted investigation due to its growth. Ultrasonography showed a hypoechoic mass in the dermis, indicating an underlying abscess. The subsequent aspiration resulted in pale yellow pus, which upon testing and culture, confirmed the presence of Mycobacterium avium complex infection, a species of NTM. This case exemplifies the synergy between imaging modalities and microbiological analysis, highlighting the crucial role of both in achieving favorable clinical outcomes in patients with suspected cutaneous NTM infections. Ultrasound can expedite diagnosis, improve treatment planning, and enhance patient care by enabling targeted interventions and monitoring response to therapy in these scenarios. However, it is the combination of pathogen-specific diagnostics that ensures accurate etiological attribution and appropriate antimicrobial stewardship.ConclusionAlthough rare, facial cutaneous infections caused by NTM still deserve thorough investigation to determine the exact cause. Ultrasound is used to identify cutaneous lesions, measure their extent, and guide surgical procedures. The ultimate diagnosis is based on microbiological confirmation.

An Approach to Selection of Face-Lift Techniques for Different Types of Faces: An Analysis of 1000 Asian Patients Over 9 Years.

A face-lift or rhytidectomy is the procedure most directly associated with rejuvenation. There are several surgical techniques for face-lifts, but criteria for the selection of techniques, based on the patient's face shape, are lacking. In this study, we report on our experience with specific indication criteria for each technique and the consequent achievement of good outcomes. From 2015 to 2023, 1 surgeon performed face-lifts on 1000 patients. Three different superficial musculoaponeurotic system (SMAS) techniques (SMAS dissection, SMASectomy, and SMAS plication) were applied depending on the degree of sagging of the patient's lower face, lateral facial profile, and SMAS mobility and condition. Superficial musculoaponeurotic system dissection was considered for the improvement of a square face, sagging jowls, and marionette lines. Superficial musculoaponeurotic system plication was applied with patients with less sagging jowls and prominent zygoma with concave lateral facial profile. SMASectomy was applied with patients with convex lateral facial profiles or when the SMAS was too thin or damaged. Patient postoperative satisfaction was surveyed using the FACE-Q score 1 year post surgery. Most of the patients attained natural-looking and long-lasting aesthetic outcomes and exhibited high satisfaction. The patients indicated that they looked about 11.2 ± 5.2 years younger than their actual age after the surgery. The mean satisfaction scores for each facial feature were as follows: cheeks (91.1 ± 7.8), marionette lines (88.5 ± 13.6), lower face and jawline (92.5 ± 14.2), under chin (87.8 ± 15.1), and neck (86.2 ± 18.5). Complications such as facial nerve injury, infection, hematoma, and flap necrosis were very rare. Establishing criteria for the selection of face-lift surgical techniques based on the degree of lower face sagging, lateral facial profile, and SMAS mobility and condition led to good outcomes. These criteria can be used by physicians to determine the most effective face-lift surgery technique based on a patient's individual features, which may improve surgical outcomes.

Facial vs Non-facial Molluscum Contagiosum Infection in Children: A Cross-sectional Study.

Molluscum contagiosum is a common skin infection affecting different body areas, including the face. Previous data have shown cases of atypical lesions, notably on the face, and it was thought relevant to further examine differences between facial and non-facial lesions. All cases of children (0-18) diagnosed with molluscum contagiosum from 2013-2022 at the paediatric dermatology clinic of Soroka University Medical Center were retrospectively reviewed, and 615 children were included in the study. Facial lesions tended to be found in younger children (p = 0.018). Non-facial lesions were more erythematous (p < 0.001), itchier (p < 0.001), and showed similar patterns of ulceration (p = 0.078) and purulence (p = 0.779). The average lesion diameter was similar in patients with or without facial lesions (p = 1). Children with facial lesions were treated differently from patients without facial lesions (p < 0.001); however, there were no differences in treatment response. This research challenges assumptions concerning the severity of facial lesions, including eyelid lesions, by revealing that, overall, they exhibit less inflammation than non-facial lesions. Despite the potential for greater psychosocial burdens and impacts on self-esteem associated with lesions on the sensitive facial area, this study provides evidence that they are not inherently more worrisome and can be managed similarly to lesions found elsewhere in the body.

Saliva-Based Protein Analysis in Pediatric Dentofacial Inflammation.

Saliva contains various proteins that are important in developing inflammatory processes and their prevention. One key aspect of saliva research is the relationship between oral infections and inflammation, and the role of some salivary proteins. To demonstrate which salivary cytokines can be biomarkers of acute odontogenic oral and facial infections in children. The study included two groups of patients: a study group of 28 children: 7 girls and 21 boys aged 3 -17 years with acute dentofacial inflammation (DI) and a control group of 52 children: 16 girls and 36 boys aged 4-17 years with uncomplicated dental caries (CE). The levels of Interleukin-5 (IL-5), Interleukin -10 (IL-10), Interleukin-17A (IL-17A), Interleukin-12p70 (IL-12p70), Eotaxin, Rantes, Vascular Endothelial Growth Factor (VEGF), and Interferon gamma-induced protein 10 (IP10) in the saliva of children in DI and CE groups were compared. Statistical analysis was performed with Statistica 13. The Student's t-test and the Wilcoxon signed-rank test were used. The results show that IL-10, IL-17A, and Eotaxin showed a statistically significant increase in the DI group compared to the CE group. The significance level for IL-10 was p=0.02, for IL-17A was equal to Eotaxin and p=0.04. The other measured parameters did not differ statistically significant between the two groups. IL-10, IL-17A, and Eotaxin can be used as potential biomarkers for tooth-related inflammatory states of the oral cavity and face in children. These biomarkers can be useful in identifying and monitoring the presence of inflammation in the oral cavity and face.

A case of facial angiosarcoma mimicking deep fungal infection

Cutaneous angiosarcoma is a rare, yet a highly aggressive skin and soft tissue tumor with a predilection to the head and neck region in white-skinned elderly males1.Cutaneous angiosarcomas have varied clinical presentations and could mimic several clinical entities making the diagnosis a challenge. Upon clinical suspicion, diagnosis is confirmed with histopathology examination and immunohistochemistry. Early diagnosis improves prognosis. We report a case of cutaneous angiosarcoma mimicking facial deep fungal infection.

Phaeohyphomycosis caused by Corynespora cassiicola, a plant pathogen worldwide

ABSTRACT Although rare, trans-kingdom infection features an interesting infection biology concept, in which highly versatile pathogenic attributes allow successful infections in evolutionarily highly divergent species. Corynespora cassiicola is a phytopathogenic fungus and occasionally causes human infections. Herein, we report a phaeohyphomycosis case caused by C. cassiicola. Given that sporadic reports may contribute to a lack of awareness of the transmission route, clinical manifestations, and diagnostic and clinical management, we systematically reviewed the cases reported thus far. Nine patients were identified and included in the pooled analysis, 88.9% (8/9) of whom were reported after 2010. All patients were from Asian, African, and Latin American countries, among whom 77.8% (7/9) were farmers or lived in areas with active agriculture. Exposed body parts were the major affected infection area, and clinical manifestations were mainly non-specific inflammatory reactions. Although biochemical and morphological examinations confirmed the presence of fungal infection, molecular analysis was used for the final diagnosis, with 77.8% (7/9) being identified by internal transcribed spacer sequencing. Whereas voriconazole, terbinafine, and AmB, either alone or in combination, resulted in successful infection resolution in most cases (5/9; 55.5%), those suffering from invasive facial infections and CARD9 deficiency showed poor outcomes. Our patient is the third case of invasive facial infection caused by C. cassiicola and was successfully treated with intravenous LAmB followed by oral voriconazole combined with topical antifungal irrigation. Molecular identification of fungus and prompt antifungal treatment is pivotal in the clinical success of patients suspected to have phaeohyphomycosis. Moreover, as evidenced by our data, itraconazole treatment is not recommended.

Facial Cellulitis Caused by Candida Guilliermondi in an Immunocompetent Patient: A Rare Case Report.

Candida cellulitis is a rare disease, primarily reported in immunocompromised patients. Atypical Candida spp. infections are increasing, largely due to the growing number of immunocompromised patients. This case report describes a 52-year-old immunocompetent patient with facial cellulitis caused by Candida guilliermondi. Candida guilliermondi has not previously been reported as a cause of facial cellulitis in either immunocompromised or immunocompetent patients. A 52-year-old, otherwise healthy, male patient presented with facial cellulitis that did not respond to intravenous antibiotics. Culture of the drained pus revealed Candida guilliermondi. The patient was successfully treated with intravenous fluconazole. This case highlights the possibility of atypical Candida spp. causing deep facial infections in immunocompetent patients. Candida guilliermondi has not been previously reported as a cause of facial cellulitis in either immunocompromised or immunocompetent patients. Healthcare providers should consider atypical Candida spp. infections in the differential diagnosis of deep facial infections in both immunocompromised and immunocompetent patients. Candida guilliermondi can cause facial cellulitis in immunocompetent patients. This has not been previously reported.Atypical Candida spp. infections should be considered in the differential diagnosis of deep facial infections in both immunocompromised and immunocompetent patients.Healthcare providers should be aware of the increasing incidence of non-Candida albicans Candida species infections, especially in immunocompromised patients.

Evaluation of long-term therapy in cats with feline asthma and chronic bronchitis

Felines Asthma (FA) und chronische Bronchitis (CB) sind häufige entzündliche Erkrankungen der Atemwege der Katze. Obwohl beide Krankheitsbilder durch eine Infiltration mit unterschiedlichen Entzündungszelltypen gekennzeichnet sind, sind die therapeutischen Maßnahmen oft ähnlich. Über mögliche Unterschiede im therapeutischen Management dieser beiden Atemwegserkrankungen ist wenig bekannt. Ziel der Studie war es daher, bei Katzen mit FA und CB die Erst- und Langzeitbehandlung, Therapieerfolg, Nebenwirkungen und Besitzerzufriedenheit zu vergleichen. 35 Katzen mit FA und 11 Katzen mit CB wurden in die retrospektive Querschnittstudie eingeschlossen. Einschlusskriterien waren kompatible klinische und radiologische Befunde sowie der zytologische Nachweis einer eosinophilen Entzündung (FA) oder einer sterilen neutrophilen Entzündung (CB) in der bronchoalveolären Lavage-Flüssigkeit (BALF). Katzen mit CB wurden ausgeschlossen, wenn Hinweise auf pathologische Bakterien vorlagen. Besitzer wurden gebeten einen standardisierten Fragebogen zum therapeutischen Management und Ansprechen auf die Behandlung auszufüllen. Im Gruppenvergleich wurden keine statistisch signifikanten Unterschiede der Therapie festgestellt. Die meisten Katzen wurden anfänglich mit Kortikosteroiden mittels einer oralen (FA 63%/CB 64%, p=1), inhalativen (FA 34%/CB 55%, p=0,296) oder injizierbaren Applikationsform (FA 20%/CB 0%, p=0,171) behandelt. Zusätzlich wurden in einigen Fällen orale Bronchodilatatoren (FA 43%/CB 45%, p=1) und Antibiotika (FA 20%/CB 27%, p=0,682) verabreicht. In der Langzeittherapie erhielten 43% der Katzen mit FA und 36% der Katzen mit CB inhalative Kortikosteroide (p=1), orale Kortikosteroide (FA 17%/CB 36%, p=0,220) und orale Bronchodilatatoren (FA 6%/CB 27%, p=0,084) sowie phasenweise Antibiotika (FA 6%/CB 18%, p=0,238). Behandlungsbedingte Nebenwirkungen (Polyurie/Polydipsie, Pilzinfektion im Gesicht und Diabetes mellitus) wurden bei 4 Katzen mit FA und 2 Katzen mit CB registriert. Die Mehrheit der Besitzer gab an, mit dem Ansprechen auf die Behandlung äußerst oder sehr zufrieden zu sein (FA 57%/CB 64%, p=1). Signifikante Unterschiede hinsichtlich des Managements und des Therapieansprechens konnten bei beiden Erkrankungen laut Besitzerbefragung nicht festgestellt werden. Laut Besitzerumfrage können chronische Bronchialerkrankungen der Katze wie Asthma und chronische Bronchitis können mit einer ähnlichen Behandlungsstrategie erfolgreich therapiert werden.

Risk Factors of Infection in Nephrotic Syndrome

Objective: To determine the risk factors of infection in patients with nephrotic syndrome. Methods: A retrospective study was conducted on 155 patients with nephrotic syndrome under our department from January 2019 to December 2019. Among them, 43 cases had infection, and the rate of infection was 27.74%. The risk factors of infection were analyzed. Results: Among the 155 patients with nephrotic syndrome, 43 cases developed infection, including 3 cases of upper respiratory tract infection (6.98%), 33 cases of lower respiratory tract infection (76.74%), 3 cases of skin infection (6.97%), 3 cases of urinary tract infection (6.97%), and 1 case of facial nerve infection (2.32%). Compared with the group without infection, the group with infection had lower serum albumin and immunoglobulin G (IgG) levels as well as higher serum creatinine and 24-hour urinary protein levels (P &lt; 0.05). Multivariate logistic regression analysis showed that decreased serum albumin (odds ratio [OR] = 1.14; P &lt; 0.01) and IgG (OR = 1.1; P &lt; 0.144) were independent risk factors for infection. Conclusion: Respiratory infection is the most common infection in nephrotic syndrome, and the decrease in serum albumin and IgG are independent risk factors for infection.

Epidemiological Analysis and Management of Patients with Facial Space Infections of Odontogenic Origin: A Retrospective Evaluation of Two Years

Objective: Odontogenic infections are one of the most common pathologies in the oral and maxillofacial regions. The spread of odontogenic infections after unsuccessful or late treatment can lead to serious complications. The aim of this study is to examine the epidemiological features and treatment management of patients with odontogenic facial abscesses.&#x0D; Methods: This retrospective study included 88 patients with odontogenic facial area abscesses treated at Afyonkarahisar health sciences university, faculty of dentistry’s maxillofacial surgery clinic between 2019-2021. The socio-demographic, socio-economic characteristics and clinical examination findings of the patients and treatment methods for odontogenic abscess were analyzed comprehensively. Data were&#x0D; evaluated using SPSS-20 and the level of significance was set at p &lt; .05.&#x0D; Results: In the two-year period between 2019 and 2021, 88 patients (44 male and 44 female, mean age was 39.72±16.42) were treated for diffuse facial infections of odontogenic origin. The most commonly involved area was the submandibular area (38.6%), the most affected tooth was mandibular 1st molar and mandibular 3rd molars (18.2%), and the most common cause was dental caries (65.90%). Incision and drainage were performed in half of the patients (36.4% intraoral, 13.6% extraoral). The most commonly used drugs were clindamycin (36.4%), amoxicillin-clavulanate, and ornidazole combination (27.3%).&#x0D; Conclusion: The results of this study confirm that odontogenic abscesses can heal without complications with timely and effective basic interventions such as incision and drainage. In this study, successful results were obtained with the parenteral clindamycin, and a combination of oral amoxicillin-clavulanate and ornidazole in the treatment of odontogenic abscesses.

Prevalence and morphological features of molar-root incisor malformation in children attending a specialist paediatric dental unit.

Molar-root incisor malformation (MRIM) is a rare dental anomaly featuring constricted cervical margins and tapered, narrow root and pulp morphology, often associated with severe toothache and infection. The aim of this study was to determine the prevalence of MRIM in children seen in a specialist paediatric dental unit of a tertiary referral hospital and to describe the characteristics of affected individuals. This study was an audit of children attending from November 2020 to November 2021. Radiographs were used to identify individuals with MRIM, and clinical data were collated. In addition, histology and microcomputed tomography (microCT) imaging were performed on teeth extracted from an affected individual. The prevalence of MRIM was five cases of 1054 children examined (0.47% or 1:210). The permanent first molars were affected in all five children and the primary second molars in two children; all children had medical comorbidities and multiple exposures to general anesthesia before 4 years of age. In addition, histological and microCT analyses displayed numerous microchannels connecting the pulp chamber to the external surface of the tooth at the furcation. Molar-root incisor malformation is an uncommon dental anomaly affecting paediatric patients with multiple comorbidities and is characterized by porosities extending from the pulp chamber to the external tooth surface, predisposing the risk of bacterial ingress from the oral cavity into the pulp chamber. Early detection may prevent atypical odontogenic facial pain and infection.

Foramen venosum: a clinicoanatomic insight into its occurrence and morphometry.

The present study aimed to evaluate the foramen venosum (FV) frequency, incidence, morphometry and relation with foramen ovale in an Indian population. The emissary vein passing through it may spread extracranial facial infections to the intracranial cavernous sinus. Due to its close proximity with the foramen ovale and its variable occurrence, awareness about its presence and anatomy is essential to neurosurgeons operating in this region. 62 dry adult human skulls were studied for the occurrence and morphometry of foramen venosum, both at the middle cranial fossa and extracranial base of the skull. Dimensions were taken using Java-based image processing program, IMAGE J. After collection of data, appropriate statistical analysis was done. The foramen venosum was observed in 49.1% skulls. Its presence was noted more frequently at the extracranial skull base than in the middle cranial fossa. No significant difference was observed between the two sides. FV at the extracranial view of the skull base had a larger maximum diameter than in the middle cranial fossa; however, the distance between FV and the foramen ovale was found to be more at the middle cranial fossa than at the extracranial view of the skull base on both the right and left side. Variations in the shape of the foramen venosum were also observed. The present study is not only of great importance to anatomists, but also to radiologists and neurosurgeons for better planning and execution of the surgical approach to the middle cranial fossa through the foramen ovale to prevent iatrogenic injuries.

Microbiology of Facial Skin Infections—Strains, Susceptibility, and Therapeutic Consequences

Skin and soft tissue infections (SSTIs) are common conditions with severe and potentially life-threatening outcomes. However, the use of antibiotics to treat these infections is controversial. This study was to identify the microorganisms responsible for facial SSTIs, their antibiotic sensitivities, and the therapeutic outcomes of treatment. This was a retrospective, observational cohort study conducted at a single oral and maxillofacial plastic surgery department. The study sample included 103 patients with facial SSTIs (61 men, 42 women) with a mean age of 41.8years (standard deviation±20.4). The predictor variables included patient characteristics, antibiotic use before the clinic visit, and the infection's site and origin. The primary outcome variable was the presence of antibiotic resistance in the bacterial strains isolated from the infections. The data were collected by reviewing the results of microbiological swabs and patient records obtained from patients with facial SSTIs. Categorical variables were described using absolute and relative frequencies, and continuous variables were described using mean and standard deviation. The association between antibiotic resistance and the predictor variables was analyzed using Pearson's χ2 test and student's t test. The most common cause of SSTI was an infected epidermal cyst (60.1%). Of all the microorganisms identified, 80.6% were Gram-positive, and 55.8% showed antibiotic resistance against one or more of the evaluated antibiotics, including several backup antibiotics. There were no identified risk factors that significantly influenced the probability of resistance, and there were no adverse events observed. The results of this study suggest that surgery should be the primary approach for treating SSTIs, as antibiotic administration may not be effective due to the unknown susceptibility of the causative strains. Antibiotics should be reserved for severe cases and high-risk patients, and if deemed necessary for SSTI management, a broad-spectrum antibiotic should be administered to cover resistant organisms.

50. Admission patterns and outcomes of patients admitted to critical care with surgically treated facial infection: an analysis of the Intensive Care National Audit and Research Centre Case Mix Programme database

Facial infections are common and can occasionally be severe. A small number of patients may develop severe sepsis or airway compromise requiring admission to a critical care unit (CCU). We examined a national intensive care database to assess patterns of admission and outcomes for patients in this cohort.

CLINICAL CASE REPORT OF POTENTIALLY LETHAL COMPLICATED SUBMANDIBULAR SPACE INFECTION.

Facial space infection is the most common infection, which is considered as the life-threatening problem. It occurs due to the poor oral hygiene and other etiological factors such as tooth infection, decreased immunity. The main path of the spread of the infections is the odontogenic path. . So the odontogenic infections are considered as the origin of space infections. Out of which the submandibular space infections is the most common. Mostly it occurs due to the periapical infection and pericoronitis around the mandibular third molar. In this report we have described 63 years old male with the submandibular space infection which appeared 7 days after visiting a local dentist. The clinical characterstics were seen and the management of submandibular space infection was done

Giant cell tumor of the bone of maxillary sinus: A rare uncommon manifestation implicated in a new mosaic of disorders?

The goal is to show a rare case of Giant Cell Tumor of Bone in the maxillary sinus implicated in a process coincidentally or casually with another type of lesion primarily developed. A 33-year-old male patient attended a surgical service, presenting swelling, obstruction and firm mass externalizing through the right nostril and perceived during 6 months. During the anamnesis, the patient stated to been underwent an incisional biopsy 4 years ago of a tumor with histopathological diagnosis of the Nasal Paraganglioma, however the immunohistochemical study was negative for this tumor. During the Computed Tomography evaluate was observed a hyperdense mass occupying the entire maxillary sinus. In the Nuclear Magnetic Resonance evaluation, it was showed a hypersignal image in the entire maxillary sinus, invading the nasal cavity and portion of skull base. A bone window was performed in the right maxillary sinus and excisional biopsy was made. In the new histopathological examination, the diagnose was consistent with Giant Cell Tumor of Bone, being observed a large number of multinucleated giant cells, some with disorganized nuclei and others similar to Touton giant cells. A large proliferation of xanthomatous-looking cells was also observed without features of malignity. At the 3-year follow-up, the patient reported no complications such as facial paralysis, infection, relapse or spread. The association between lesions occurring in the same location requires further study, possibly implicated in a new model of clinical, microscopic, and genetic disorders. Thus, masses originating from chronic inflammatory tissue may have the potential to transform into GCTB?

Cavernous Sinus Thrombosis as a Complication of Cerebro-Rhino Orbital Mucormycosis Associated With Covid-19: A Case Report

Cavernous sinus thrombosis is a life-threatening condition that arises as a complication of facial infection, sinusitis, orbital cellulitis, pharyngitis, or otitis of fungal or bacterial origin or after traumatic injury or surgery. Rhinocerebral mucormycosis is an aggressive infection that, depending on its level of extension, affects nasal passages, paranasal sinuses and the orbital region.

Submandibular space infection – A threatening plethora

Facial space infection is the most common infection, which is considered as the life­-threatening problem. It occurs due to the poor oral hygiene and other etiological factors such as tooth infection, decreased immunity. The main path of the spread of the infections is the odontogenic path. The patients having the habit of smoking, tobacco use, chewing areca nuts etc. are at the high risk of having odontogenic infection. So the odontogenic infections are considered as the origin of space infections. Out of which the submandibular space infections is the most common. Mostly it occurs due to the periapical infection and pericoronitis around the mandibular third molar. In this report we have described 38 years old female with the submandibular space infection which appeared 10 days after visiting a local dentist. The clinical characterstics were seen and the management of submandibular space infection was done.

Relationship of Diabetes Mellitus Among The Patients Reporting With Fascial Space Infection

Objective: To determine the frequency of diabetic patients having Odontogenic Maxillofacial space infections in local population. Methodology: This cross sectional study was carried out from 1-3-2020 to August 2020 in the Department of Oral and Maxillofacial Surgery, Pakistan Institute of Medical Sciences, Islamabad, to assess the frequency and association of diabetics with facial space infection. A total of 70 patients of both genders with Odontogenic maxillofacial infection were included in the study. Patients were stratified into three age groups; Age group 1 was from 18-30, Age group 2 from 31-45 years and Age group 3 from 46-60 years. This form includes demographic data (age, gender, contact information, address), medical history (diabetic or non-diabetic) along with sign and symptoms were noted in the Performa. The SPSS version 20.0 was used to analyze the data. Mean and standard deviation was calculated for age. Frequency and percentages were used for the gender and diabetes mellitus. Results: A total of 70 patients having Odontogenic maxillofacial space infection. Of these 70 study cases, 42 (60%) were females and 28 (40%) were males with mean age of 40.97±10.32 years. Out of 70 patients, 55 (78.57%) were diabetic and 15 (21.43%) patients were non-diabetic patients. Conclusion: Diabetic patients are more prone to Odontogenic maxillofacial space infections and due to poor diabetic control multispace infection along with severe complications may occur.

Predictors of Infection and Benefit of Antibiotics in Gunshot Wounds to the Face.

Gunshot wounds (GSWs) to the face are at high risk for infection due the extent of tissue injury and often-observed violation of oral and sinus cavities. Given the ambiguous data on antibiotic benefit in GSW to the face, the purpose of this study is to characterize antibiotic usage, infection details, and risk factors associated with higher infection rates in GSW to face. We conducted a retrospective review of patients presenting with GSW to the face from 2009 to 2017. The primary outcome was to identify risk factors associated with infections in patients with facial GSWs. A stepwise multivariate linear regression analysis was performed to determine the impact of specific injury details. Two hundred sixty-nine patients qualified for the study. Demographic information and details of hospital stay are presented in tables. Most patients (88.8%) received admission antibiotics. Facial infections were observed in 36 patients (13.4%). The infected cohort required more antibiotic days (P < 0.001), higher percentage of invasive airway procedures (P = 0.01), longer length of stay (P < 0.001), greater number of surgeries (P < 0.022), and higher readmission rates (P < 0.001). Factors associated with head or neck infections included oral cavity (odds ratio, 1.23; P = 0.04) and sinus involvement (odds ratio, 1.10; P = 0.045). Bullet trajectories that violated the oral or maxillary sinus cavities were associated with higher head and neck infection rates. Patients without oral cavity or sinus involvement had a lower chance (4.1%) of developing an infection and therefore may have marginal benefit from antibiotics.