Pediatric maxillofacial infections with cellulitis: A retrospective study

The aim of this retrospective study was to evaluate the characteristics of oral and maxillofacial infections associated with cellulitis in a series of pediatric patients over a two year period. One hundred and five patients in the age group between three and fourteen, who were hospitalized and diagnosed with infections in the oral and maxillofacial region, were selected for the study. The study variables included the etiology of the infection, the signs and symptoms of the infection, the associated microbiology, the antibiotic coverage and the need for surgical intervention. Seventy two patients were diagnosed with infections of odontogenic origin and thirty three patients had infections of non-odontogenic origin. About 82% of the patients diagnosed with odontogenic infection had an associated abscess and/or space infection. A rare type of chemical cellulitis which occurred due to iatrogenic complications was seen in four patients. About 20% of the patients had undergone herbal medication prior to hospitalization. The most common organism isolated in odontogenic infections was Streptococcus viridans and Peptostreptococcus. In the non-odontogenic group, H Influenza type B was the commonly isolated organism. A combination of amoxicillin and clavulanic acid for aerobic, and metronidazole for anaerobic infections were the most commonly used antibiotics. Surgical intervention was required in about 73% of the cases. This study indicates that odontogenic infections form a majority of the oral and maxillofacial infections with cellulitis. Incision and drainage is the mainstay of treatment of abscess and space infections. In the rural and semi urban areas, herbal medication still exists as the first line of treatment, even in cases of severe space infections. Iatrogenically induced infections, though relatively a small percentage, can be potentially dangerous.