-
Minimally invasive and inexpensive percutaneous abscess drainage using an indwelling needle cannula.American Journal of Otolaryngology 2020Abscess is still a formidable disease and requires adequate drainage. Moreover, drainage in the head and neck area needs cosmetic care, especially in the pediatric...
PURPOSE
Abscess is still a formidable disease and requires adequate drainage. Moreover, drainage in the head and neck area needs cosmetic care, especially in the pediatric population. In this report, we introduce our method of percutaneous abscess drainage using an indwelling needle cannula.
PATIENTS AND METHODS
Ten pediatric and five adult patients with cervical and/or facial abscess treated with this drainage method were retrospectively reviewed. Using an indwelling needle cannula (18-14 G Surflow®, Terumo, Tokyo, Japan), abscesses were penetrated under ultrasonic examination. Once purulent retention was identified, the inner metal needle was removed and the outer elastic needle was left and fixed. The outer needle was connected to the tube for continuous suction drainage for large abscess.
RESULTS
The primary diseases of these abscesses were cervical abscess of dental origin (5), purulent lymphadenitis (3), pyriform sinus fistula (2) and subperiosteal abscess due to mastoiditis (2), circumorbital cellulitis (1), infection of Warthin's tumor (1), and unknown origin (1). The median (range) duration of drainage was 4 days (3-9 days). Abscesses were successfully treated, and no patients required additional incision for abscess drainage. No apparent scars after drainage were observed.
CONCLUSION
This technique resembles the usual venous placement of an indwelling needle cannula and is thought to be familiar to physicians. Although simple and inexpensive, this drainage is safe, effective, and minimally invasive for the treatment of abscess.
Topics: Abscess; Aged; Catheterization; Catheters, Indwelling; Child; Child, Preschool; Drainage; Face; Female; Humans; Infant; Male; Middle Aged; Minimally Invasive Surgical Procedures; Neck; Retrospective Studies; Treatment Outcome
PubMed: 32911391
DOI: 10.1016/j.amjoto.2020.102664 -
European Journal of Paediatric Dentistry Jun 2019The aim of this study was the assessment of prevalence, distribution, and treatment of deep caries and odontogenic abscess formation in children who received emergency...
AIM
The aim of this study was the assessment of prevalence, distribution, and treatment of deep caries and odontogenic abscess formation in children who received emergency dental general anaesthesia (DGA) at the University Hospital of Cranio-Maxillofacial and Oral Surgery of Innsbruck, Austria.
MATERIALS AND METHODS
The study population was composed of 1,184 consecutive cases of emergency DGA from January 2008 to June 2014, in patients ?16 years who had presented with odontogenic pain and/or swelling. Under DGA, the tooth causative for the acute pain, and all teeth with deep caries had been routinely removed. From patient files, demographic data, abscess location and therapy, and the number of teeth extracted under DGA were recorded and analysed by means of descriptive statistics.
RESULTS
In 549 cases (46.4%) (mean age 5.29±2.39 years), an abscess formation was recorded; 90.5% of all abscesses were submucous, and 9.5% affected fascial spaces. Decayed primary molars and maxillary primary incisors and canines were most often causative for abscess formation. Drainage was in most cases performed by tooth extraction with/without an intraoral incision under antibiotic therapy. Per case, a mean of 5.91±4.04 primary teeth were extracted. In 77 individuals (mean age 9.83± 2.59), a mean of 1.92±1.02 permanent first molars were extracted.
CONCLUSION
In the study population, prevalence of deep caries and abscess formation was alarmingly high. In consideration of the medical risks and high efforts immanent in DGA, educational measures should address parents in order to raise awareness of their responsibility for their children´s health.
Topics: Abscess; Anesthesia, Dental; Anesthesia, General; Child; Child, Preschool; Dental Caries; Humans; Prevalence; Retrospective Studies
PubMed: 31246087
DOI: 10.23804/ejpd.2019.20.02.07 -
Australian Dental Journal Mar 2022In Australia, because of inequity in dental service accessibility and affordability, patients can see general medical practitioners (GPs) for acute dental conditions.
BACKGROUND
In Australia, because of inequity in dental service accessibility and affordability, patients can see general medical practitioners (GPs) for acute dental conditions.
METHODS
This cross-sectional study consisted of surveys distributed to the board registered GPs practising in Australia. The main outcome measures included statistical analysis of GPs managing different dental emergency scenarios and their confidence and expectations in managing dental emergencies.
RESULTS
A total of 425 GPs participated in the study. The sample primarily consisted of GPs practising in metropolitan clinics (n = 315). Most participants reported that they would refer to the dentist for mobilized tooth (n = 402). There was a negative correlation between GPs with 5-29 years of experience and traumatized tooth management (P < 0.05). GPs aged between 40 and 49 years were more inclined to treat patients with mobilized teeth [Multivariate (MV): 0.42(0.09-0.74)]. However, GPs with 0-5 years of experience were less likely to manage patients with dental abscess [MV: -0.52(-0.80 to -0.24)].
CONCLUSION
Most GPs referred dental emergencies to dentists. GP management of dental emergencies were predominantly palliative. Therefore, opportunities for collaborative practice models amongst GPs and dentists may be needed to bridge the gap in the regional and remote locations.
Topics: Adult; Australia; Cross-Sectional Studies; Emergencies; General Practitioners; Humans; Middle Aged; Referral and Consultation
PubMed: 34591999
DOI: 10.1111/adj.12878 -
Frontiers in Public Health 2022Early Childhood Caries (ECC) remains a global issue despite numerous advancements in research and interventional approaches. Nearly, 530 million children suffer from...
Early Childhood Caries (ECC) remains a global issue despite numerous advancements in research and interventional approaches. Nearly, 530 million children suffer from untreated dental caries of primary teeth. The consequences of such untreated dental caries not only limit the child's chewing and eating abilities but also, significantly impact the child's overall growth. Research has demonstrated that ECC is associated with nearly 123 risk factors. ECC has also been associated with local pain, infections, abscesses, and sleep pattern. Furthermore, it can affect the child's emotional status and decrease their ability to learn or perform their usual activities. In high-income countries, dental care continues to endorse a "current treatment-based approach" that involves high-technology, interventionist, and specialized approaches. While such approaches provide immediate benefit at an individual level, it fails to intercept the underlying causes of the disease at large. In low-income and middle-income countries (LMICs), the "current treatment approach" often remains limited, unaffordable, and unsuitable for the majority of the population. Rather, dentistry needs to focus on "sustainable goals" and integrate dental care with the mainstream healthcare system and primary care services. Dental care systems should promote "early first dental visits," when the child is 1 year of age or when the first tooth arrives. The serious shortages of appropriately trained oral healthcare personnel in certain regions of the world, lack of appropriate technologies and isolation of oral health services from the health system, and limited adoption of prevention and oral health promotion can pose as critical barriers. The oral health care systems must focus on three major keystones to combat the burden of ECC-1. Essential oral health services are integrated into healthcare in every country ensuring the availability of appropriate healthcare accessible and available globally, 2. Integrating oral and general healthcare to effectively prevent and manage oral disease and improve oral health, 3. Collaborating with a wide range of health workers to deliver sustainable oral health care tailored to cater to the oral health care needs of local communities.
Topics: Child; Child, Preschool; Humans; Dental Caries; Public Health; Sustainable Development; Oral Health; Health Promotion
PubMed: 36330110
DOI: 10.3389/fpubh.2022.931243 -
Cureus Apr 2022Odontogenic infections commonly arise from poor dental hygiene that forms dental caries, which can eventually progress to gingivitis and periodontitis. The authors...
Odontogenic infections commonly arise from poor dental hygiene that forms dental caries, which can eventually progress to gingivitis and periodontitis. The authors present a case of facial swelling diagnosed as a periapical abscess with soft tissue swelling that extended into both the maxilla and mandible.
PubMed: 35497083
DOI: 10.7759/cureus.24434 -
Journal of Medicine and Life Aug 2022Inappropriate antibiotic prescriptions contributed to a global issue of antimicrobial resistance. This study aimed to assess the prevalence of bacterial pathogens and...
Inappropriate antibiotic prescriptions contributed to a global issue of antimicrobial resistance. This study aimed to assess the prevalence of bacterial pathogens and antimicrobial resistance isolated from maxillofacial infections (MIs). Two hundred and twenty-two patients with different MIs were included in this study. Swab samples were taken from the site of infections. Samples were cultured, and isolated bacteria were identified using various biochemical tests. Antimicrobial resistance patterns of isolates were assessed by the disk diffusion method. The mean age of the patients was 50.8 years. The male-to-female ratio was 127/95 (P<0.05). Smoking and alcohol consumption were found in 60.36% and 37.38% of patients, respectively. Most patients had a ≤1-week infection duration (P<0.05). Abscess lesion was the most predominant infection type (P<0.05). The prevalence of aerobic bacteria among abscess, pus localization, and deep facial infections was 59.33%, 64.28%, and 46.66%, respectively. The prevalence of anaerobic bacteria among abscess, pus localization, and deep facial infections was 40.66%, 23.80%, and 53.33%, respectively. (10.36%) and (8.55%) had the uppermost distribution amongst all examined samples. Isolated bacteria exhibited the uppermost resistance rate toward penicillin (65.76%), tetracycline (61.26%), gentamicin (58.10%), and ampicillin (57.65%) antimicrobials. The lowest resistance rate was obtained for linezolid (25.67%), ceftriaxone (31.08%), and azithromycin (31.08%) antimicrobials. Linezolid, ceftriaxone, and azithromycin had effective antimicrobial activities toward bacteria isolated from MIs. Therefore, cautious antibiotic prescription might decrease the prevalence of antimicrobial resistance in dental and maxillofacial infections.
Topics: Abscess; Ampicillin; Anti-Bacterial Agents; Anti-Infective Agents; Azithromycin; Bacteria; Bacterial Infections; Ceftriaxone; Drug Resistance, Bacterial; Female; Gentamicins; Humans; Linezolid; Male; Microbial Sensitivity Tests; Middle Aged; Penicillins; Surgery, Oral; Tetracyclines
PubMed: 36188658
DOI: 10.25122/jml-2021-0149 -
Journal of Advanced Pharmaceutical... Dec 2022Stitch abscesses are abscesses that develop following surgical procedures as a result of suture infections. Because of nonabsorbable sutures, the material reacts with...
Stitch abscesses are abscesses that develop following surgical procedures as a result of suture infections. Because of nonabsorbable sutures, the material reacts with connective tissue, generating adhesions around the stitch. The use of this type of material increases the risk of infection. The aim of this study was to establish awareness on the management strategy of suture stitch abscess among dental students. An online survey consisting of ten questions about suture stitch abscess along with sociodemographic factors was circulated among equal numbers of 2 years, 3 years, final years, and compulsory rotatory residential internship (CRRI). The data obtained from the questionnaire were transferred to Microsoft Excel and imported to SPSS software for statistical analysis. Interns are more aware about the complications and management strategy of suture stitch abscesses compared to others. Awareness on the management strategy of suture stitch abscess is important, and it helps to reduce the side effects to improve the outcomes. Educating the risk factors, signs and symptoms, and management strategy is the best way to help raise awareness.
PubMed: 36798554
DOI: 10.4103/japtr.japtr_309_22 -
Respiratory Medicine Sep 2023Lung abscess (LA) is a serious respiratory infection often followed by several weeks of antibiotic treatment. This study described the clinical presentation of LA,...
INTRODUCTION
Lung abscess (LA) is a serious respiratory infection often followed by several weeks of antibiotic treatment. This study described the clinical presentation of LA, treatment duration and mortality in a contemporary Danish population.
METHODS
In a retrospective multicenter cohort study at four Danish hospitals, patients diagnosed with LA were identified using the International Classification of Diseases and Related Health Problems 10th revision (ICD-10) between 2016 and 2021. A predefined data collection tool was used to extract data on demographics, symptoms, clinical findings and treatment.
RESULTS
Of 302 patients, 222 with LA were included after review of patient records (76%). Mean age was 65 years (54-74), 62.9% was male and 74.9% were ever-smokers. Chronic obstructive pulmonary disease (COPD) (35.1%), use of sedatives (29.3%) and alcohol abuse (21.8%) were common risk factors. Dental status was reported in 51.4%, whereof 41.6% had poor dental status. Patients presented with cough (78.8%), malaise (61.3%) and fever (56.8%) Patients were hospitalized for a median of 14 days (interquartile ranges, IQR 7-21) and median duration of antibiotic treatment was 38 days (IQR 30-51). All-cause mortality after 1, 3 and 12 months was 2.7%, 7.7% and 15.8%, respectively.
CONCLUSION
Risk factors for LA include COPD and use of sedatives, alcohol abuse, and poor dental status. Despite long-term antibiotic treatment, long-term mortality is markedly high.
Topics: Humans; Male; Aged; Lung Abscess; Cohort Studies; Disease Progression; Alcoholism; Pulmonary Disease, Chronic Obstructive; Anti-Bacterial Agents; Denmark
PubMed: 37302422
DOI: 10.1016/j.rmed.2023.107305 -
Cureus Apr 2021Paediatric orbital cellulitis is a potential sight- and life-threatening condition. It is a serious infection in children that can result in significant complications,...
Paediatric orbital cellulitis is a potential sight- and life-threatening condition. It is a serious infection in children that can result in significant complications, including blindness, cavernous sinus thrombosis, cerebral venous sinus thrombosis, meningitis, subdural empyema, and brain abscess. Of the patients with orbital cellulitis, 17% died from meningitis, and 20% of the survivors had permanent loss of vision. Therefore, the potential for sight- and life-threatening complications makes prompt diagnosis and early treatment very important. We report here a case of a two-year-old girl who presented with a three-day history of left periorbital swelling, preceded by left upper perioral swelling that extended upward to the left cheek and left lower lid and was associated with low-grade fever. The patient had been admitted and was treated as having left preseptal with facial cellulitis; the patient was started on intravenous amoxicillin/clavulanic acid (200 mg three times per day dose), and chloramphenicol ointment was applied to the periorbital area. On day 3, the condition worsened, and dental examination showed multiple dental caries, upper gum swelling and abscess, and mobility of teeth 61 and 62 (two baby teeth). Contrast-enhanced computed tomography (CECT) of the orbit, paranasal, and brain showed a left periosteal abscess collection extending to the inferomedial region of the orbit. Examination and tooth extraction were performed under general anesthesia. The intraoperative results showed the presence of a left upper gum abscess, which was possibly the primary source of infection. Clinical improvement was observed postoperatively. Orbital cellulitis can be a complication of a dental abscess. This case emphasizes the importance of primary tooth care in children. A lack of care can result in fatal complications.
PubMed: 33981511
DOI: 10.7759/cureus.14392 -
Infection and Drug Resistance 2021To assess the views of the dental interns (DIs) and general dental practitioners (GDPs) in the Asir region of Saudi Arabia on antibiotic prescription for endodontic...
Comparison of the Views of the General Dental Practitioners and Dental Interns in Asir, Saudi Arabia on Antibiotic Prescription for Endodontic Therapy: A Cross-Sectional Study.
AIM
To assess the views of the dental interns (DIs) and general dental practitioners (GDPs) in the Asir region of Saudi Arabia on antibiotic prescription for endodontic therapy.
METHODS
The link to a cross-sectional online survey with 16 quantitative and qualitative questions was e-mailed to 60 DIs at the College of Dentistry of King Khalid University (group 1 [G1]) and 60 GDPs at the governmental primary healthcare centers in the Asir region of Saudi Arabia (group 2 [G2]). The data obtained from the survey were then subjected to a comparative statistical analysis. The inter-group statistical comparison of the distribution of categorical variables was tested using the chi square test or the Fisher's exact probability test if more than 20% of the cells had an expected frequency of less than 5. The p-values > 0.05 were considered statistically significant. The data were statistically analyzed using Statistical Package for Social Sciences (SPSS version 22.0, IBM Corporation, USA) for MS Windows.
RESULTS
The response rate was 83.3% for G1 and 63.33% for G2. Of the participants in G2, 39.5% had 1-5 years' clinical experience (the participants in G1 had no clinical experience). The number of endodontic emergency patients seen per day was significantly higher in G1 (88% and 63.2% of the participants in G1 and G2, respectively, were seeing 0-3 endodontic emergency patients per day). There was an insignificant difference between G1 and G2 in awareness of the existence of antibiotic prescription guidelines in endodontic therapy (57.9% and 56.0%, respectively; p > 0.05). There was also an insignificant difference between the groups in the rate of antibiotic prescription for endodontic problems, with 84% of the G1 participants and 86.8% of the G2 participants prescribing antibiotics only for limited patients. In the analysis of the clinical-vignette items (Q11-16), it was found that the rate of antibiotic prescription did not significantly differ between G1 and G2 (p > 0.05). No significant difference was found in the rate of antibiotic prescription for symptomatic reversible pulpitis, symptomatic irreversible pulpitis, and chronic apical periodontitis cases (p > 0.05). In contrast, the rate of antibiotic prescription for the symptomatic apical periodontitis, acute apical abscess, and systemic complications cases differed significantly (8% for G1 and 18.4% for G2, 54% for G1 and 76.3% for G2, and 98% for G1 and 73.7% for G2, respectively).
CONCLUSION
No significant difference in the rate of antibiotic prescription was found between the DIs and GDPs in this study. However, both groups showed an inappropriate rate of antibiotic prescription for some endodontic conditions. Further and more extensive studies involving a wider geographical region and different colleges of dentistry in Saudi Arabia are recommended.
PubMed: 34393493
DOI: 10.2147/IDR.S321938