Diagnosis and Treatment of Lip Infections

Acute Lower Lip Swelling: A Mere Anaphylactic Reaction or a Rare Abscess Location?

An abscess is a collection of pus secondary to an immune response to a pathogen. It can occur anywhere in the body, with the skin as the most common organ involved. A lip abscess is a rare condition. Generally, it may be due to an infective agent such as a virus or bacteria entering through a skin wound, or through hematogenous spread when there is a severe underlying condition such as a general condition disorder or immunodeficiency. It requires hypervigilance during the examination and throughout the treatment course with intravenous antibiotic therapy and urgent surgical drainage, as it may cause significant complications regarding localization, lymphovascular drainage, and ultimate spread. Persistent abscess, necrotic tissue, or cavitated lesions are worrisome and it is important to rule out immunosuppression or a methicillin-resistant staphylococcus. In this case, a 22-year-old male patient with a unilateral lip abscess, misdiagnosed as an allergic food reaction, responded well to external drainage and antibiotic therapy.

Effect of procalcitonin on the severity and prognostic value of elderly patients with a severe infection of oral and maxillofacial space

This study aimed to investigate the effect on the severity and prognostic value of serum procalcitonin for elderly patients with oral and maxillofacial infections. We divided 163 elderly patients with severe oral and maxillofacial infection into survival and death groups according to the prognosis between June 2015 and May 2021, measured serum procalcitonin by enzyme-linked immunosorbent assay on the 1st, 2nd, 3rd, 5th, and 7th day after admission for the dynamic changes of serum procalcitonin level, collected the general physiological and biochemical indexes for the scores of acute physiology and general chronic condition, compared the correlation between serum procalcitonin, mean platelet count and APACHE score, analyzed the prognostic value of serum procalcitonin levels at different time after admission by ROC curve. The serum procalcitonin level increased significantly in both groups after admission, sharply increased at first and then rapidly decreased in the survival group, and continued to rise or declined slowly with fluctuation of high level in the death group. There was a negative correlation between serum procalcitonin level and mean platelet count (r = -0.698, P < .05) and a positive correlation between serum procalcitonin and APACHE II (R = 0.803, P < .05). The ROC curve showed that the serum procalcitonin level had little value on the first day and great value on the third day in predicting the prognosis of elderly patients with severe oral and maxillofacial infection (PCT1d = 0.539, PCT3d = 0.875, P < .05). The serum procalcitonin level is correlated with the severity of the disease in elderly patients with severe oral and maxillofacial space infection. Dynamic observation of it is helpful for the prognosis judgment of patients. After admission, serum procalcitonin level on the third day has a great value for the prognosis judgment of elderly patients with severe oral and maxillofacial space infection.

Immunocompetent Young Patient Presenting with Unilateral Lip Abscess Due to Peeling Exfoliated Lip Skin

Lip abscess is a rare condition encountered in clinical practice. Generally, it may be due to an infective agent, such as virus, bacteria, entering through a skin wound, or it can be seen through hematogenous spread when there is a serious underlying condition such as a general condition disorder or immunodeficiency. It requires rapid diagnosis and treatment as it may cause significant complications in terms of localization and lymphovascular drainage. In this case report, an 18-year-old male patient with unilateral lip abscess that regressed rapidly with external drainage and antibiotic therapy is presented with imaging and clinical-laboratory findings.