Bacteriology of deep neck infections: analysis of 634 patients

Abstract

Background: The aim of this study was to review the bacteriology of deep neck infections (DNI) and identify the factors that influence the incidence of causative bacteria. Methods: A retrospective analysis of 634 patients with DNI was performed. Statistical analysis was used to compare the incidence of common pathogens in various conditions such as age of the patients, aetiology and associated diabetes mellitus. Results: Bacteria were isolated in 514 cultures (81%). Aerobic bacteria were isolated from 246 cultures (39%) and anaerobic bacteria from 61 cultures (10%). Both aerobic and anaerobic bacteria were isolated from 207 cultures (32%). The most common aerobic bacteria were Streptococcus pyogenes (41%) and Staphylococcus aureus (32%). The most common anaerobic bacteria were Peptostreptococcus species (28%), followed by Prevotela species (8%) and Proprionibacterium species (7%). The incidence of anaerobic bacteria was higher in adults, in patients with infections of dental origin and in non-diabetic patients. Conclusions: The bacteriology of DNI is polymicrobial, including both aerobic and anaerobic bacteria. The incidence of anaerobic bacteria is higher in adults, in patients with infections of dental origin and in non-diabetic patients.

Odontogenic facial swelling of unknown origin

“…Failed clinical care from inadequate diagnosis and delayed management can progress into facial cellulitis 1 and cause life-threatening complications (such as septicaemia, cavernous sinus thrombosis, airway obstruction and mediastinitis). [2][3][4][5] Patients with acute facial cellulitis are often admitted to major hospitals as the last resort of treatment, resulting in considerable morbidity in terms of social and economic losses to individuals and society at large. 1,6 Odontogenic infections comprise around 50.0% to 62.8% of facial cellulitis, 2,7 with non-odontogenic causes contributing to the rest.…”

Neck abscess as the initial manifestation of pharyngeal cancer

“…No bacteria were identified in a patient with a DNI. No organism was isolated from 20-30 % of pus samples (Lee & Kanagalingam, 2011;Celakovsky et al, 2015). This high proportion of no growth was probably due to the prompt use of high-dose antimicrobials early in the course of the disease.…”

“…In a retrospective study of 634 patients with DNI by Celakovsky et al (2015), aerobic and anaerobic bacteria were isolated from 39 % and 10 % of cultures, respectively. Both aerobic and anaerobic bacteria were isolated from 32 % of cultures.…”

Deep neck infections of non-odontogenic origin: clinical manifestation and treatment

“…Deep neck infections of nonodontogenic origin are characterised by different clinical and microbiological manifestations compared to odontogenic infections. Dental infections are typically associated with a higher incidence of anaerobic bacteria compared to infections of non-dental aetiology [4]. Trismus is a rare symptom of non-odontogenic deep neck infection and can be very helpful in differentiating odontogenic and non-odontogenic infections.…”