Is There Association Between Severe Multispace Infections of the Oral Maxillofacial Region and Diabetes Mellitus?

Clinical and bacteriological influence of diabetes mellitus on deep neck infection: Systematic review and meta‐analysis

“…First, mean age was significantly higher in patients with diabetes than in nondiabetic patients, without significant heterogeneity among studies (Table ). These results are consistent with the clinical experience that elderly patients with diabetes are particularly prone to infection, and senescence of the immune system can also alter host defense mechanisms . Moreover, the prevalence of diabetes has been reported to increase in older groups in the general population …”

“…Many previous bacteriological analyses have shown that the most commonly isolated organism in patients with diabetes with facial space infections is K. pneumoniae , followed by Streptococcus spp., whereas the most common organisms isolated from nonpatients with diabetes were Streptococcus spp. followed by Staphylococcus spp . In the present meta‐analysis, patients with diabetes displayed a significantly higher prevalence of identifying K. pneumoniae (RR, 3.28; 95% CI, 2.52–4.26) than nonpatients with diabetes without heterogeneity.…”

“…Diabetes mellitus is considered to adversely impact the immune system, along with causing vascular insufficiency . Although several reports have described clinical features of deep neck infection in patients with diabetes compared to nondiabetic patients, all such reports have been retrospective observational studies, including our own previous report . Systematic reviews and meta‐analyses are essential for developing new hypotheses that can then be tested in interventional studies .…”

“…This higher prevalence in patients with diabetes was attributed to impaired neutrophilic functions and complement activation . Such reduced immunity, coupled with the increased oropharyngeal K. pneumoniae colonization in immunocompromised hosts, has been considered to explain the predominance of K. pneumoniae . Empirical antimicrobial coverage of K. pneumoniae should thus be considered mandatory in patients with diabetes showing deep neck infections.…”

Analysis of glycosylated hemoglobin (HbA1c) level on maxillofacial fascial space infection in diabetic patients

“…Many of them divided the groups by blood glucose level on admission or past medical history of DM. They concluded that diabetic patients are more likely to develop complications, greater incidence rates of involved spaces, and abnormal hematologic findings 19 20 21 . Sim et al 13 reported that physical and emotional stress increases blood glucose level via activation of both the adrenergic and glucocorticoid systems.…”