Oral Abscess in Libyans: Hematological, Bacteriological and Immunological Features

The clinical and laboratory aspects were studied in 27 Libyan patients with oral abscess (age: 18-45 years; sex: 14 males, 13 females) and compared with 25 healthy volunteers (age: 19-47 years, sex: 13 males, 12 females) as controls. The diagnosis of oral abscess was made on clinical presentation, such as facial swelling with severe pain, tenderness and mild to moderate fever (37.7-38.2°C) for 8-10 days duration together with hematological investigations such as blood hemoglobin, ESR, total and differential counts. Neutrophilic leukocytosis with raised ESR was indicative of bacterial infection which was confirmed by bacteriological culture and antibiotic sensitivity studies. The bacterial strains isolated from pus were staphylococcus aureus (5/27), Betahemolytic streptococci (2/27), Alpha-hemolytic streptococci (Streptococcus sanguis) (6/27), Veillonella parvula (5/27), Streptococcus pneumonia (1/27) and Bacteriodes oralis (3/27). The five pus specimens (5/27) which did not give any growth on culture, showed coarse spirochate and fusiform organisms in gram smear suggesting fuso-spirochetal infection. The raised serum IgG, C3, C4 and haptoglobulin levels were indicative of the presence of severe inflammation due to infection. The low serum IgA level may possibly be due to enzymic destruction of IgA by bacterial proteases. The rise in alpha-1-antitrypsin, may be secondary to acute phase response which is believed to be important primarily an a inhibitor of proteases.