Characterization of patients with odontogenic necrotizing soft tissue infections in the head and neck area. A retrospective analysis

Authors

  • Signe Undall-Behrend Hansen Department of Odontology, University of Copenhagen, Copenhagen, Denmark
  • Frederik Viktor Bang Jespersen Department of Odontology, University of Copenhagen, Copenhagen, Denmark
  • Merete Markvart Department of Odontology, University of Copenhagen, Copenhagen, Denmark
  • Ole Hyldegaard Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
  • Christina Caroline Plaschke Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Copenhagen University Hospital, Copenhagen, Denmark
  • Thomas Bjarnsholt Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark; Department of Immunology and Microbiology, Costerton Biofilm Center, University of Copenhagen, Copenhagen, Denmark
  • Claus Henrik Nielsen Department of Odontology, University of Copenhagen, Copenhagen, Denmark; nstitute for Inflammation Research, Copenhagen University Hospital, Copenhagen, Denmark
  • Simon Storgård Jensen Department of Odontology, University of Copenhagen, Copenhagen, Denmark; Deparment of Oral & Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark

DOI:

https://doi.org/10.1080/00016357.2023.2254389

Keywords:

Cervical necrotizing fasciitis, head and neck infection, necrotizing fasciitis, necrotizing soft tissue infection, odontogenic infection

Abstract

Objective: Necrotizing soft-tissue infection (NSTI) in the head and neck area may develop from odontogenic infections. The aim of this study was to characterize patients with NSTIin the head and neck with odontogenic origin in a well-defined prospectively collected cohort.

Material and methods: Patients with NSTIin the head and neck, hospitalized between 2013 and 2017 at Copenhagen University Hospital and registered in the Scandinavian INFECTdatabase were included. Medical records of identified patients and from the INFECTdatabase were screened for a defined set of data including the primary focus of infection, comorbidities, predisposing factors, clinical and radiographic diagnostics, course of treatment, and treatment outcome.

Results: Thirty-five patients with NSTIin the head and neck area were included in the study. Atotal of 54% had odontogenic origin, primarily from mandibular molars, and 94% had radiographic signs of infectious oral conditions. Overall, comorbidities were reported in 51% with cardiovascular disease being the most prevalent. In 20%, no comorbidities or predisposing conditions could be identified. The overall 30-day mortality rate was 9%.

Conclusions: More than half of NSTIcases in the head and neck region had an odontogenic origin, and special attention should be paid to infections related to mandibular molars. 

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Published

2024-09-17

Issue

Vol. 82: Acta Odontologica Scandinavica

Section

Research article