All cases of dental, oral and pharyngeal infections that were sent to a specialist’s consultation in a secondary health care unit were retrospectively collected and analysed, in Mikkeli Central Hospital in southeastern Finland during a 25 months period.
There were a total of 406 cases, equalling annual incidence of 183 cases/100,000 inhabitants. 160 subjects (40%) needed intravenous antibiotics and in-patient treatment, on an average of 3.0 days. Tonsillar infections were most prevalent (28%, n = 114), separately from unspecified pharyngitis (6%, n = 24) and mononucleosis (2%, n = 10) cases. 97 (24%) peritonsillar abscesses were recorded, of those 52% required immediate tonsillectomy in general anesthesia. One fifth (80 cases) were dental infections, 34 cases (8%) derived from major salivary glands and 47 (12%) from miscellaneous or idiopathic reasons. 16 patients (4%) had sublingual or submandibular cellulitis or abscess, all of them caused by dental infections. 69% of these cases required immediate incision and drainage combined with extraction of the infected teeth. An average of 7.8 days of treatment in the hospital ward including 2.0 days (mean) in the intensive care unit was needed among these patients. In the bacterial analysis of the samples, most prevalent result was miscellaneous “normal flora” (48%) following by S. pyogenes (15%), β-hemolytic G-group streptococci (9%), miscellaneous streptococcal “normal flora” (6%) and S. anginosus -group (5%).
It is important to recognize patients with imminent oropharyngeal infection among all common infections—a part of the cases can be serious and even life threatening requiring intravenous antibiotics and immediate surgical treatment.
Conflict of interest: None declared.