Diabetes mellitus as a background multi-organ pathology in patients with maxillofacial phlegmons

Gromov Aleksandr Leonidovich, Ivanov Sergey Viktorovich, Tkachenko Nadezhda Fedorovna, Suleymanova Navad Hajiahmadikizi

A retrospective analysis of 514 patients with purulent complications of acute odontogenic infection (2012, 2000-2010) was performed. Patients are distributed according to the form of the inflammatory process, the presence and nature of the background pathology (diabetes mellitus). The evaluation of homeostasis indicators (the content of red blood cells, platelets, hemoglobin, white blood cells, biochemical parameters) was performed. Most often, diabetes occurs in patients with a local form of purulent infection, somewhat less often in patients with a systemic inflammatory response syndrome. Statistically significant differences were observed in the study groups only in terms of glycemic levels and bilirubin content. The average bed-day was 14.8. Lethality - in 1 case in a patient with phlegmon of the bottom of the mouth and neck, total mediastinitis, severe sepsis and pulmonary embolism. If the patient is diagnosed with criteria for systemic inflammatory response syndrome, the threshold value of glycemia, indicating the possibility of developing diabetes, may be a level of 10-11 mmol/l. Symptoms of diabetes can be masked by manifestations of a common form of purulent infection.

Keywords:odontogenic infection, diabetes mellitus, background pathology, maxillofacial region, competing diseases, local process.