Deep Neck Infection: Review of 286 Cases

Gorjón, Pablo Santos; Pérez, Pedro Blanco; Martín, Ana Cristina Morales; Dios, Juan Carlos del Pozo de; Alonso, Santiago Estévez; Cabanillas, María Isabel Calle

doi:10.1016/j.otoeng.2012.01.006

Cited by 65 publications

(51 citation statements)

References 19 publications

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“…Similar to the DNIs, cervical NFs can also lead to serious complications, and due to its more aggressive behaviour, NF shows even higher mortality rates [19,20]. Although DNI and NF are usually separately discussed, NF can be a complication of DNI [6,18,21]. This is in accordance with our findings that phlegmonous deep neck space infections-especially in the parapharyngeal space-can be accompanied or complicated by a superficial spread showing the classical symptoms of cervical NF.…”

Section: Discussionsupporting

confidence: 89%

“…When DNI is diagnosed, the major goal is to race against the infection to prevent the development of further complications (mediastinitis, airway obstruction, sepsis, pneumonia, cranial nerve palsy, jugular vein thrombosis) [17,18]. Similar to the DNIs, cervical NFs can also lead to serious complications, and due to its more aggressive behaviour, NF shows even higher mortality rates [19,20].…”

Section: Discussionmentioning

confidence: 99%

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Severe neck infections that require wide external drainage: clinical analysis of 17 consecutive cases

Horváth

Varga

et al. 2014

Eur Arch Otorhinolaryngol

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Infections in the neck layers and spaces are potentially life-threatening diseases causing further complications, like mediastinitis, airway obstruction, or sepsis. Despite of the need for a conservative approach, they still regularly require surgical intervention. Records of 17 patients with severe neck infections that were treated by wide external incision and open wound management were retrospectively analyzed. The aim of the study was to clinically characterize these most serious neck infections. The most common presenting symptoms were neck pain and tense neck mass (94-94%) regularly with fever (65%), always accompanied by a marked elevation of C reactive protein level (average 192 uG/l). These findings were constant and very similar among both the deep neck infection and necrotizing fasciitis cases. More than half of the patients (53%) had at least one systemic co-morbidity. The parapharyngeal space was most commonly affected (83%), but extended disease involving more than two major neck regions was found in 13 cases (76%). Dental (29%) was the most common primary infection, followed by peritonsillar abscess (23%), Microbiological results showed a wide variety of corresponding bacteria. Mediastinitis was developed in three cases (18%), and airway obstruction requiring tracheostomy in two cases (12%). All the patients survived. Severe neck infections are a heterogenous group of diseases regarding to the primary site of infection, microbiology, localisation and host reaction. However, rapidly developed, painful, tense neck mass with a highly elevated CRP level should always alert for an extended or phlegmonous process in the layers or spaces of the neck.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Severe neck infections that require wide external drainage: clinical analysis of 17 consecutive cases

Horváth

Varga

et al. 2014

Eur Arch Otorhinolaryngol

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“…When assessing the severity and prognosis of cellulitis, attention must be paid, in particular, to warning signs indicating propagation of infection through the body, such as body temperature increase above 39 °C, appreciable jaw contracture, signs of inflammation spreading to the surroundings along the large neck vessels, oedema or skin reddening in the jugular area, pain under the sternum, but also swollen eyelids and retrobulbar pain, stridor, cough and pain in the chest (3)(4)(5)1). Appropriate timing of surgical intervention is an important factor in cellulitis therapy: it should be conducted early and correctly, adhering (also today) to the rule "Ubi pus, ibi evacuo…"…”

Section: Introductionmentioning

confidence: 99%

Deep Neck infections of Odontogenic Origin and Their Clinical Significance. A Retrospective Study from Hradec Králové, Czech Republic

Doležalová

Zemek

Tuček

2015

Acta Med. (Hradec Kralove, Czech Repub.)

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Summary:Introduction: Cellulitis remains a very serious disease even today. Mortality, which varied between 10-40%, has been reduced owing to the standard securing of airway patency and use of an appropriate surgical treatment approach. Materials and methods: A total of 195 patients were hospitalised for cellulitis at the University Hospital in Hradec Králové during 2007-2011. The following parameters were evaluated: age, gender, dependence of incidence of the disease on the season of the year, frequency of attacks of the particular areas and their clinical characteristics, aetiology of the inflammation, types of patient complaints, prevalence of current systemic diseases, results of microbiological and selected laboratory analyses, socio-economic status of the patients, and duration of patient stay at the hospital. Statistical analysis was performed by using Pearson's correlation coefficient, the statistical significance level was p < 0.05. Results: The mean age of the patients was 39.8 years. The group of 195 patients included 108 (55%) males and 87 (45%) females. The mean time between the first symptoms of the disease and admission to the Department was 5 days. From among the 195 patients, 116 (59.5%) were working persons, 79 (40.5%) were non-working (children, students, unemployed persons, women on maternity leave, retired people). The odontogenic origin of the disease was verified in 173 (88.7%) patients. In total, 65 (33.3%) patients had no coinciding complicating systemic disease, 22 (11.3%) patients had diabetes mellitus. The most frequent symptom of cellulitis was painful swelling, found in 194 (99.5%) patients, followed by jaw contracture, found in 153 (78.5%) patients. Conclusion: The results are largely very similar to those of previous studies performed in other countries, except that we found no correlation between the prevalence of cellulitis and the socio-economic status, nor have we confirmed Klebsiella pneumoniae sp. as the cause of cellulitis in patients with diabetes mellitus.

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“…7,10 In addition, it can help to establish the need, extent, and boundary of surgery. Delay in diagnosis causes poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

Facial Paralysis and Mediastinitis Due to Odontogenic Infection and Poor Prognosis

Bucak

Ulu²,

Kokulu³

et al. 2013

Journal of Craniofacial Surgery

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Cervical necrotizing fasciitis (CNF) is a rare, rapidly advancing infection that involves the skin, the subcutaneous fibrofatty tissue, as well as the superficial and deep fascia and can cause life-threatening complications. The most frequent initiating factors in the head and neck region are a primary odontogenic infection, a peritonsillar infection, as well as posttraumatic or iatrogenic skin and mucosal injuries. Necrotizing fasciitis (NF) can expand within hours, and the reported mortality rate is up to 75% with delay interference. If the patients have any risk factors, poor prognosis can be seen. In this study, 1 patient with CNF with a history of peritonsillar infection and 2 patients with CNF who had a history of odontogenic infection with spreading to the temporal region and the mediastinum were described, with information of the literature and a clinical experience that was gained from 5 patients with NF who were seen at our clinic in the recent year, despite the fact that CNF was not seen up to last year. None of the patients had any risk factors. One of them had a worse clinical state with ascending infection to the temporal region, cranial nerve paralysis, and descending necrotizing mediastinitis, but he recovered from NF. After the oral intake began, dyspnea due to aspiration was seen and he died because of sepsis and multiorgan dysfunction. We aimed to attract attention to the importance of dental pathologies and increased mortality in a healthy patient.

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Deep Neck Infection: Review of 286 Cases

Cited by 65 publications

References 19 publications

Severe neck infections that require wide external drainage: clinical analysis of 17 consecutive cases

Severe neck infections that require wide external drainage: clinical analysis of 17 consecutive cases

Deep Neck infections of Odontogenic Origin and Their Clinical Significance. A Retrospective Study from Hradec Králové, Czech Republic

Facial Paralysis and Mediastinitis Due to Odontogenic Infection and Poor Prognosis

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