[Diffuse cervico-facial cellulitis: 32 cases in Libreville].

Abstract

Objective: The aim of this study was to analyze the predisposing factors and the diagnostic and therapeutic aspects of diffuse cervico-facial cellulitis.

Material and methods: This retrospective study examined the records of all 32 patients admitted to the ENT and cervico-facial department of the Omar Bongo Ondimba Army Teaching Hospital in Libreville with diffuse cervico-facial cellulitis, from January 2006 through December 2010.

Results: The study included 18 women (56%) and 14 men (44%) with a mean age of 28 years. At admission, 28 patients (87.5%) had already received anti-inflammatory drugs and 25 (78%) one or more antibiotics. Two patients were HIV+. The main route was dental for 21 patients (66%), tonsillar for 4 (13%), submandibular for 2 (6%), parotid for 2 cases (6%), cutaneous for 1 (3%) and unspecified in 2 more (6%). The cellulitis was pseudo-phlegmonous in 24 patients (75%) and gangrenous in 8 cases (25%). It extended to the mediastinum in six patients (19%). The bacteriological study, carried out in 24 cases (75%), found 14 cases of aerobic germs. Medical or medical and surgical treatment led to cure for 30 patients (94%). Two patients (6%) died.

Conclusion: Treatment of cervico-facial cellulitis must be early and multidisciplinary. Self-medication with anti-inflammatory drugs for bucco-pharyngeal infections without appropriate antibiotic treatment is the principal predisposing factor.