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    Clinical Characterics, Laboratory Features, and Management of Odontogenic Facial Cellulitis
    (Aves Yayincilik, Ibrahim Kara, 2018) Kaman, Ayse; Teke, Turkan Aydin; Oz, Fatma Nur; Bayhan, Gulsum Iclal; Metin, Ozge; Aydin, Zeynep Gokce Gayretli; Durmus, Sevgi Yasar
    Objective: Dental caries remain one of the most common chronic diseases in childhood, globally. The purpose of this study is to determine clinical characteristics and treatment modalities of pediatric patients with odontogenic facial cellulitis. Material and Methods: Medical records of children with odontogenic facial cellulitis hospitalized in pediatric infectious disease clinic were analyzed retrospectively between January 2013 and December 2017. Results: Ninety-eight patients (43 girls, 55 boys) with median age of 86 months (min-max: 19-207 months) were evaluated. Forty-five (45.9%) patients had no regular toothbrushing habits. Forty-eight (48.9%) patients had no any dental treatment procedure history. Eighteen (18.3%) patients had never recoursed to a dentist. Seventy-five patients (76.5%) were diagnosed with odontogenic facial cellulitis for the first time. Four patients (4%) were hospitalized with the same diagnosis previously. On admission, 37 (37.8%) patients had fever. On admission, the mean white blood cell (WBC) count, erythrocyte sedimentation rate, and C-reactive protein (CRP) were 11.981 +/- 4.433/mm(3), 29.1 +/- 17.6 mm/h and 35.2 +/- 39.4 mg/L, respectively. The mean duration of intravenous antibiotic treatment was 5.5 +/- 2.5 days, and total medical treatment was 12.5 +/- 2.9 days. Ampicillin-sulbactam was started to 82 (83.7%) of the patients. Clindamycin was added to 15 (15.3%) patients. Increased mean WBC count on admission was correlated with duration of hospital stay (p = 0.036), while increased CRP level was correlated with total medical treatment duration (p = 0.032). Patients who received clindamycin had longer duration of intravenous and total medical treatment (p < 0.001 and p < 0.001). Conclusion: If dental caries are not recognized and treated immediately, they may spread into surrounding connective tissue as cellulitis and may lead to hospitalization in young patients. Oral health is a mainstone of life-long well-being, so oral health problems should be considered as a major public health problem and preventive measures should be taken to improve oral health.
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    Risk Factors of Stenotrophomonas maltophilia Blood Stream Infections: Comparison With Other Gram-Negative Blood Stream Infections in Children
    (Lippincott Williams & Wilkins, 2020) Aydin, Zeynep Gokce Gayretli; Tanir, Gonul; Bayhan, Gulsum Iclal; Teke, Turkan Aydin; Akcan, Ozge Metin; Kaman, Ayse; Durmus, Sevgi Yasar
    Background: Stenotrophomonas maltophilia, is a nonfermentative, aerobic, Gram-negative bacilli which is intrinsically resistance to several antibiotics. Treatment options for this bacteria are quite different from the other Gram-negative bacilli, which can represent a therapeutic challenge. To initiate appropriate empiric treatment and to reduce mortality, differentiation of S. maltophilia from other Gram-negative bacteria is critically important. The aim of this study is to distinguish the risk factors of S. maltophilia blood stream infections (BSI) from other Gram-negative BSI. Methods: This was a retrospective, case-control study. Patients with S. maltophilia BSI were selected as cases and patients with non-S. maltophilia Gram-negative BSI were selected as controls. Demographic and clinical characteristics of patients were recorded. Results: Forty-eight cases with S. maltophilia BSI and 144 controls were enrolled in the study. Risk factors for S. maltophilia BSI compared with the control group includes prior use of antibiotics, especially carbapenem, pediatric intensive care unit stay, mechanical ventilator use, indwelling catheters and duration of hospitalization. Conclusions: Breakthrough infection by S. maltophilia can occur in severely ill patients being treated with carbapenem. In the presence of risk factors, to reduce morbidity and mortality, S. maltophilia should be kept in mind when starting empiric treatment.