Skip to main content

Advertisement

Log in

To Compare the Efficacy of C-Reactive Protein and Total Leucocyte Count as Markers for Monitoring the Course of Odontogenic Space Infections

  • Research Paper
  • Published:
Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Objective

To compare the efficacy of CRP and TLC as markers for monitoring the course of odontogenic space infections (OSI) in 50 patients.

Methods

A Clinical severity scale (CSS) was developed to grade the severity of infections in patients. Blood samples were taken preoperatively and postoperatively at day 1, day 2, day 3 and day 7 for measuring the levels of CRP and TLC. The trends of CRP and TLC were analysed against the CSS. The data was subjected to paired “t” test, ANOVA, Spearman rank correlation, Pearson’s bivariate correlation as appropriate.

Results

The CRP values were elevated in all 50/50 (100 %) patients as compared to TLC which were elevated in 32/50 (64 %) patients only. The CSS displayed a high internal consistency and reliability (Cronbach α = 0.748). A significant strong positive correlation (ρ = 0.754) was found between CRP and CSS as compared to a moderate correlation (ρ = .607) between TLC and CSS.

Conclusion

CRP displayed a more consistent relation with clinical severity of the infection than TLC. Hence it could be more reliably employed to judge the progress in a patient with OSI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ylyjoki S, Suuronen R, Somer HJ, Meurman JH, Lindqvist C (2001) Differences between patients with or without the need for intensive care due to severe odontogenic infections. J Oral Maxillofac Surg 59:867–872

    Article  Google Scholar 

  2. Ren YF et al (2007) Rapid quantitative determination of C-reactive protein at chair side in dental emergency patients. J Tripleo 104(1):49–55

    Google Scholar 

  3. Sganga et al (1985) Hepatic protein repriosation after trauma and sepsis. J Surg 120:189–199

    Google Scholar 

  4. Sabel KG, Wadsworth C (1979) C-reactive protein in early diagnosis of neonatal septicemia. Acta Paediatr Scand 68:825–831

    Article  CAS  PubMed  Google Scholar 

  5. Bali R, Sharma P, Gaba S (2015) Use of metronidazole as part of an empirical antibiotic regimen after incision and drainage of infections of the odontogenic spaces. Br J Oral Maxillofac Surg 53(1):18–22. doi:10.1016/j.bjoms.2014.09.002

    Article  PubMed  Google Scholar 

  6. Bahl R, Sandhu S, Singh K, Sahai N, Gupta M (2014) Odontogenic infections: microbiology and management. Contemp Clin Dent 5(3):307–311

    Article  PubMed  PubMed Central  Google Scholar 

  7. Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: a severity of disease classification system. Crit Care Med 13(10):818–829

    Article  CAS  PubMed  Google Scholar 

  8. Póvoa P (1998) C-reactive protein as an indicator of sepsis. Intensive Care Med 24(10):1052–1056

    Article  PubMed  Google Scholar 

  9. Barreto VT, Isaac A, Bhimidi P, Nguyen C, Jones G (2013) Trends of C-reactive protein laboratory values with white blood cell count levels in maxillofacial infections. J Oral Maxillfac surg 71(9):e31–e32

    Article  Google Scholar 

  10. Vigushin DM, Pepys MB, Hawkins PN (1993) Metabolic and scintigraphic studies of radioiodinated human C-reactive protein in health and disease. J Clin Investig 91:1351–1357

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Pepys MB, Baltz ML (1983) Acute phase proteins with special reference to C-reactive protein and related proteins (pentraxins) and serum amyloid A protein. Adv Immunol 34:141–212

    Article  CAS  PubMed  Google Scholar 

  12. Ylijoki S, Suuronen R, Jousimies-Somer H, Meurman JH, Lindqvist C (2001) Differences between patients with or without the need for intensive care due to severe odontogenic infections. J Oral Maxillfac surg 59(8):867–872

    Article  CAS  Google Scholar 

  13. Seppänen L, Lauhio A, Lindqvist C, Rautemaa R (2008) C-reactive protein in predicting the need for reoperation in odontogenic maxillofacial infections requiring hospital care. In: 18th European congress of clinical microbiology and infectious diseases. Barcelona, Spain

  14. Bakathir AA, Moos KF, Ayoub AF, Bagg J (2009) Factors contributing to the spread of odontogenic infections. Sultan Qaboos Univ Med J 9(3):296–304

    PubMed  PubMed Central  Google Scholar 

  15. Sharma A, Gokkulakrishnan S, Shahi AK, Kumar V (2012) Efficacy of serum CRP levels as monitoring tools for patients with fascial space infections of odontogenic origin: a clinicobiochemical study. Natl J Maxillofac Surg 3(2):148–151

    Article  PubMed  PubMed Central  Google Scholar 

  16. Chang J-S, Yoo K-H, Yoon SH, Ha J, Jung S, Kook M-S et al (2013) Odontogenic infection involving the secondary fascial space in diabetic and non-diabetic patients: a clinical comparative study. J Korean Assoc Oral Maxillofac Surg 39:175–181

    Article  PubMed  PubMed Central  Google Scholar 

  17. Travis RT, Steinle CJ (1984) The effects of odontogenic infection on the complete blood count in children and adolescents. Pediatr Dent 6(4):214–219

    CAS  PubMed  Google Scholar 

  18. Aminzadeh A, Parsa E (2011) Relationship between age and peripheral white blood cell count in patients with sepsis. Int J Prev Med 2(4):238–242

    PubMed  PubMed Central  Google Scholar 

  19. Boucher NE, Hanharan JJ, Kihara FY (1967) Occurrence of C-reactive protein in oral diseases. J Dent Res 46(3):624–627

    Article  CAS  PubMed  Google Scholar 

  20. Heimdahl A, Nord CE (1983) Orofacial infections of odontogenic origin. Scand J Infect Dis 39(Suppl):86–91

    CAS  Google Scholar 

  21. Kallio LU, Kallio MJ, Peltola H, Eskola J (1994) Serum C-reactive protein, erythrocyte sedimentation rate, and white blood cell count in acute hematogenous osteomyelitis of children. Pediatrics 93(1):59–62

    PubMed  Google Scholar 

  22. Clyne B, Olshaker JS (1999) The C-reactive protein. J Emerg Med 17(6):1019–1025

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

I thanks Mr. Varun Arora, Bio-statistician for his assistance with the statistical analysis of my research study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rishi Bali.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Statement

Obtained for experimentation with human subjects from patients as well as from ethical committee.(F/Ethical/1593). The study design was approved by the Board of Studies of the University.

Informed Consent

An informed consent was obtained from all the patients.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bali, R., Sharma, P., Ghanghas, P. et al. To Compare the Efficacy of C-Reactive Protein and Total Leucocyte Count as Markers for Monitoring the Course of Odontogenic Space Infections. J. Maxillofac. Oral Surg. 16, 322–327 (2017). https://doi.org/10.1007/s12663-016-0978-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12663-016-0978-3

Keywords

Navigation