DIAGNOSIS AND TREATMENT OF LIP INFECTIONS

Abstract Purpose Staphylococcus aureus (S. aureus) is a gram-positive, facultative anaerobic, cocci bacteria which naturally colonizes the skin. S. aureus can cause a mild to severe infection depending on location, depth of invasion, and immune status. Guidelines regarding treatment of patients with lip infections are scant. The purpose of this project was to present the diagnosis, management and outcome of a cohort of patients with lip infections caused by S. aureus. Material & Methods This was a retrospective cohort study of patients with a lip infection caused by S. aureus treated by Emory Oral and Maxillofacial Surgery Service (Atlanta, GA). Predictor variables were patient demographics, clinical presentation, laboratory findings, imaging characteristics, intervention, and length of stay (LOS). The outcome variable was infection resolution or persistence. Data were collected using a standardized collection form. Descriptive statistics were computed. Results Seven patients (mean age, 38 years) with lip swelling met inclusion criteria. Patients were not recently hospitalized and/or recent surgery. Patients had immunodeficiency virus or other medical comorbidities. Radiographic finding was consistent with abscess formation. Management consisted of surgical intervention with antibiotics or antibiotics only. Lip cultures demonstrated S. aureus with methicillin sensitive or resistant S. aureus. Treatment was intravenous followed by oral antibiotics. Average length of inpatient stay was 4 days. There were no postoperative complications. All lip infections achieved complete clinical resolution. Conclusion In this cohort, treatment of lip swelling caused by S. aureus required surgical intervention and/or antibiotics. Immune compromise and antibiotic resistance should be considered in a patient with a similar presentation.