Analysis of systemic and local odontogenic infection complications requiring hospital care - 08/08/11

Doi : 10.1016/j.jinf.2008.06.002

Lotta Seppänen ^a, Anneli Lauhio ^b, Christian Lindqvist ^c,^d, Riitta Suuronen ^e, Riina Rautemaa ^a,^d,^⁎
^a Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, FIN-00014 Helsinki, Finland
^b Division of Infectious Diseases, Department of Medicine, Helsinki University Central Hospital, FIN-00029 Helsinki, Finland
^c Institute of Dentistry, University of Helsinki, FIN-00014 Helsinki, Finland
^d Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, FIN-00029 Helsinki, Finland
^e Regea Institute for Regenerative Medicine, University of Tampere and Tampere University Hospital, FIN-33520 Tampere, Finland

Corresponding author at: Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, P.O. Box 21, Haartmaninkatu 3, FIN-00014 Helsinki, Finland. Tel.: +358 9 1912 6894; fax: +358 9 1912 6382.

Summary

Objective

Analysis of systemic and local odontogenic infection complications requiring hospital care.

Methods

All cases of odontogenic infections requiring hospital care, which were adjudicated in the Finnish Patient Insurance Centre during 2000–2003, were analysed. Patient characteristics, and the course and outcome of infection were reviewed.

Results

The study material consisted of 35 patient cases; 15 male, 20 female; mean age 38.4 (16–67) years. The mean length of hospital stay was 14.8 (2–81) days. Nine patients required intensive care for mean 6.2 (2–19) days. Twenty-five (71%) patients developed local infection complications with cellulitis and abscess formation, and 10 (29%) patients a generalised or metastatic infection complication. The length of hospital stay among patients with systemic complications was longer than with local complications, 30.2 (2–81) days vs. 8.0 (2–34) days (p=0.0144). All patients with local complications survived but three of the 10 patients with systemic complications died. Medically compromised patients with underlying disease developed more often systemic infection complications than previously healthy patients (p=0.0028).

Conclusions

Medically compromised patients appear more susceptible to systemic rather than local infection complications with a need for significantly longer hospital stay and with an increased risk for fatal complications.

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Keywords : Antibiotic prophylaxis, Bacteraemia, Dental infection, Distant site infection, Endocarditis, Hospital care, Metastatic infection, Septicaemia, Severe odontogenic infection