Endocrine Abstracts

Objective

To summarize the characteristics and treatment experience of cervicofacial odontogenic cellulitis in diabetic patients and to provide clinical basis for the diagnosis and treatment.

Material and method

Retrospectively analysed 50 cases of cervicofacial cellulitis in diabetics in the ENT department of Taher Sfar Mahdia, Tunisia from from january 2015 to december 2018.

Results

A total of 50 diabetic patients were included in this study. The average age was 40 years (Range: 7 and 71 years). In terms of their sex distribution, we found a male dominance. The level of hygiene of the patients was poor: 80% did not brush their teeth. 15 patients were cigarette smokers and 3 were alcohol consumers. The waiting period before consultation varied between 1 and 30 days. 30% of patients said they had taken a no steroidal anti-inflammatory drug. 50% of patients were under antibiotic treatment the time of the consultation. The clinical sign was mainly an exo-buccal tumefaction in 40 patients. The results showed that 35 of cases were located under the chin. As for the clinical form, 60% of the patients presented a serous acute cellulitis, 30% a suppurative acute cellulitis and 10% a chronic cellulitis. The main etiology was in 90% dental pulp necrosis. The treatment consisted in prescription of antibiotic and intensified insulin therapy in all of cases, a surgical drainage in 30% of cases and an extraction of the affected tooth in 70% of the cases. The treatment allowed to achieve a favorable evolution in 98% of the cases. One patient died due to mediastinitis.

Conclusion

the inadequate treatment or chronic dental infection, associated with immunodepression and some cofactors (tobacco, alcohol.) can lead to severe case of cellulitis. Medical and surgical management should be carried out as soon as possible to prevent serious complications.