Clinical and bacteriological differences of deep neck infection in pediatric and adult patients: Review of 123 cases

Shimizu, Yuichi; Hidaka, Hiroshi; Ozawa, Daiki; Kakuta, Risako; Nomura, Kazuhiro; Yano, Hisakazu; Watanabe, Ken Ichi; Katori, Yukio

doi:10.1016/j.ijporl.2017.05.028

Cited by 30 publications

(15 citation statements)

References 23 publications

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“…Our results are consistent with other studies which also report the monomicrobial pattern. 12 However, other pathogens have also been reported as more frequent for pediatric peritonsillar and DNI, like Staphylococcus aureus and Streptococcus viridans. 8,12,17,18 The present results may be explained by the use of high dose of empirical antibiotics before admission and surgical drainage.…”

Section: Discussionmentioning

confidence: 99%

“…12 However, other pathogens have also been reported as more frequent for pediatric peritonsillar and DNI, like Staphylococcus aureus and Streptococcus viridans. 8,12,17,18 The present results may be explained by the use of high dose of empirical antibiotics before admission and surgical drainage. As previously mentioned, more than a half of our patients underwent antibiotic therapy before admission, mainly amoxicillin-clavulanate and penicillin.…”

Section: Discussionmentioning

confidence: 99%

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Management of pediatric peritonsillar and deep neck infections‐ cross‐ sectional retrospective analysis

Menezes

Ribeiro

Guimarães³

et al. 2019

World j. otorhinolaryngol.-head neck surg.

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ObjectiveDeep neck infections (DNI) are responsible for significant morbidity in children and healthcare expenditures. Few studies exist specifically addressing the clinical and epidemiologic characterization and management of DNI's in the pediatric population. Our goal was to analyse the demographic characteristics, clinical presentation, diagnostic and therapeutic approaches of peritonsillar and DNI in pediatric patients.MethodsThe medical records of patients, aged up to 18 years, admitted for peritonsillar and DNI at our department, from 2011 to 2016, were retrospectively reviewed and compared with the literature available. Ninety‐eight patients were enrolled.ResultsThe mean age was higher in patients with peritonsillar abscess and lower in patients with retropharyngeal and parapharyngeal infections. Admissions have significantly increased from 2011. There was a seasonal variation for DNI incidence, with a peak incidence in Summer and Spring. All patients included were treated as inpatient and received empirical intravenous antibiotic therapy and steroids regardless of drainage procedures. Incision and drainage was performed in 72 patients. The hospital length of stay was higher among patients with retropharyngeal abscess and in the group with complications. Only 2 patients developed complications during hospital stay. The most common microbiological pattern was monomicrobial and the most commonly isolated pathogens were Streptococcus Pyogenes, Streptococcus Mitis and anaerobic bacteria.ConclusionsSurgical incision and drainage followed by intravenous antibiotic and steroids proved to be successfull with low morbidity related to surgical approach. However, in selected cases, medical therapy may be an alternative to surgical management in uncomplicated infections.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Management of pediatric peritonsillar and deep neck infections‐ cross‐ sectional retrospective analysis

Menezes

Ribeiro

Guimarães³

et al. 2019

World j. otorhinolaryngol.-head neck surg.

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“…In contrast, polymicrobial infection with group A Streptococcus along with anaerobes is the major pathogens in adult patients. Besides, tracheostomy was less frequently required for treatment in children than in adult patients [36][37][38].…”

Section: Discussionmentioning

confidence: 99%

A dangerous cause of airway obstruction: deep neck infection

2020

Signa Vitae

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Deep neck infection (DNI) is an infection in the fascial spaces of the neck. Complications of DNI, including mediastinitis, internal jugular vein thrombosis, and upper airway obstruction, are severe and potentially life threatening. Therefore, early identification and accurate management of DNI are essential. We review the anatomy of the deep spaces of the neck to determine the route of DNI spread so that emergency doctors, physicians, and otorhinolaryngologists can quickly recognize the development of lethal complications of DNI, such as asphyxia from airway obstruction.

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“…DNM is caused by the downward spread of oropharyngeal and cervical infections. Pharyngeal infection is the most frequent causative infection for DNM in adults [ 1 , 2 ], and DNM is a rare complication that develops in 9% of deep neck infections [ 8 , 9 ]. Meanwhile, in children, retropharyngeal abscess is the most frequent cause of DNM.…”

Section: Discussionmentioning

confidence: 99%

A Case of Descending Necrotizing Mediastinitis in a Previously Healthy Child

Okumura

Tetsuka

Yamaguchi

et al. 2021

Case Reports in Pediatrics

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Descending necrotizing mediastinitis (DNM) is a rare complication of oropharyngeal and cervical infection, especially in children. We report a case of DNM secondary to a cervical abscess in a previously healthy 1-year-old boy. The patient presented with redness and swelling of the neck and fever. He was treated with an antimicrobial agent for the diagnosis of cervical lymphadenitis. On the sixth day, a huge mediastinal abscess was found, and he was admitted to the intensive care unit. He was successfully treated with surgical drainage and appropriate antimicrobial therapy. The pus culture isolated multiple bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). Although we did not use an antimicrobial agent covering MRSA, the symptoms and test results improved. Washing with drainage was effective. The patient required multidisciplinary treatment, and we collaborated with specialists in other departments. DNM is a severe disease in which team medical care is needed to provide appropriate treatment.

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Clinical and bacteriological differences of deep neck infection in pediatric and adult patients: Review of 123 cases

Cited by 30 publications

References 23 publications

Management of pediatric peritonsillar and deep neck infections‐ cross‐ sectional retrospective analysis

Management of pediatric peritonsillar and deep neck infections‐ cross‐ sectional retrospective analysis

A dangerous cause of airway obstruction: deep neck infection

A Case of Descending Necrotizing Mediastinitis in a Previously Healthy Child

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