Prevalence of Diabetes Mellitus and Clinicodemographic Profiles of Patients with Head and Neck Infections in a Philippine Tertiary Government Hospital

Abstract

Objective: To determine the prevalence of diabetes mellitus among patients admitted for head and neck infections and describe their clinicodemographic features. Methods: Design: Retrospective Case Series Setting: Tertiary Government Training Hospital Participants: Forty-two (42) patients Results: Out of 211 adult patients admitted for head and neck infections during the study period, 42 (20%) were diagnosed to have concomitant diabetes mellitus (DM). Only 6 (14%) were known to have DM before admission while 28 (67%) were found to have DM only after admission. The most common site of infection was the neck (11; 26%). More than half of the patients (24; 57.1%) had infections in the head only, 17 (40.5%) had infections in the neck only, and 1 (2.4%) had infections in both the head and neck regions. Among these, 26 (61.9%) had infection in one site only, 15 (35.7%) had infections in two sites and one (2.4%) had infections in three sites. The majority (28; 66.7%) had an unknown etiology of infection with spontaneous appearance of redness and swelling in the involved area. Six (14.3%) were odontogenic, five (11.9%) were due to skin trauma, and three (7.1%) were due to nasal mucosal trauma. Available cultures in 14 patients revealed 12 (86%) with aerobic microorganisms and two (14%) with anaerobic growths. Half of the aerobic cultures grew K. pneumoniae. All patients were started on empiric intravenous antibiotics and over half of them (52.4%) needed surgical management. More than half (27; 64.3%) suffered from diabetic head and neck-associated complications, categorized into orbital (56%), organ/systemic (26%), local (11%), and neural (7%). Despite these complications, the majority (37, 86%) went home improved while five (12%) expired. Conclusion: This study found that 20% of patients admitted for head and neck infections during the study period had concurrent DM. Guided by known clinicodemographic characteristics, patients admitted with suspicious head and neck infections must be promptly screened for concomitant DM and properly managed before substantial morbidity and death ensue. Otolaryngologists head and neck surgeons, endocrinologists, general practitioners and patients alike must be cognizant of diabetic head and neck infections so that they can be prevented or managed early before complications set in.