Diagnostic and therapeutic approaches in deep neck infections: an analysis of 74 consecutive patients

Bal, Kemal Koray; Ünal, Murat; Delıalıoğlu, Nuran; Oztornaci, Ragip Onur; İsmi, Onur; Vayısoğlu, Yusuf

doi:10.1016/j.bjorl.2020.07.002

Cited by 12 publications

(5 citation statements)

References 38 publications

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“…This helps to relieve pressure and reduce the spread of the infection. Besides, several risk factors for the development of severe deep neck infections and an affection of the mediastinum have been identified, such as age older than 55 years, cardiopulmonary comorbidities, nutritional status or especially diabetes mellitus [8] , [9] , [10] , [11] .…”

Section: Discussionmentioning

confidence: 99%

Isolation of Mycoplasma salivarium in the empyema of a diabetic patient with deep neck infection and necrotizing mediastinitis: A case report

Weng,

2023

IDCases

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Section: Discussionmentioning

confidence: 99%

Isolation of Mycoplasma salivarium in the empyema of a diabetic patient with deep neck infection and necrotizing mediastinitis: A case report

Weng,

2023

IDCases

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“…In the study by Hacı et al examined 85 DNI in 2016, it has been stated that ampicillin sulbactam was used most frequently as an antibiotic and treatment has been performed by combining metronidazole or clindamycin in many cases (15). In the study conducted by Bal et al with 74 patients with DNI in 2020, it has been stated that 49 patients were treated with paranteral ampicillin sulbactam and clindamycin treatment (16). In our study, in the empirical antibiotic treatment, 1 (2.8%) patient was initiated meropenem, 1 (2.8%) patient ertapenem, 6 (16.6%) patients ceftriaxone + metronidazole, 26 (72.2%) patients ampicillin sulbactam + clindamycin, 2 (2.8%) patients ampicillin sulbactam.…”

Section: Discussionmentioning

confidence: 99%

“…It has been emphasized that abscess culture is a more important test than blood culture (17). In the study of Bal et al (16), growth has been detected in 85% of the abscess cultures of the patients, and it has been stated that the positivity in the culture results could increase if the anaerobic bacteria culture was performed under appropriate conditions. In a study conducted by Kataria et al with 76 patients in 2015, it has been reported that 50% of staphylococci and streptococci were grown in culture (18).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Empirical Ampicillin Sulbactam + Clindamycin Treatment in Deep Neck Infections in Adults

Alagöz¹,

Delibas²,

Bal³

et al. 2021

JEURMEDS

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Objective: Deep neck infection (DNI) is defined as an infection that occurs in the potential cavities and fascia of the neck. DNI is an Ear Nose Throat (ENT) emergency that needs to be treated early and effectively. It is important to preserve the airway patency, especially in the follow-up. DNI can be seen in all age groups, which are difficult diagnose due to location differences and have a high risk of complications. Nowadays, odontogenic infections are the most common cause of infections in adults. To investigate the effectiveness of DNI empirical ampicillin sulbactam + clindamycin treatment in adults.Material and Methods: The information of 36 patients who were hospitalized and treated with the diagnosis of deep neck infection between October 2017 and September 2020 was reached in University of Health Sciences: Adana City Training and Research Hospital ENT outpatient clinic. Results:The ages of the patients were between 19 and 73, with a mean of 41 ± 14.433. As the age increased, the duration of treatment was prolonged. In empirical treatment, meropenem 1 (2.8%), ertapenem 1 (2.8%), ceftriaxone + metronidazole 6 (16.7%), ampicillin sulbactam + clindamycin 26 (72.2%), ampicillin sulbactam 2 (2%, 8) has been used in the patient. While 30 (83.3%) patients were drained, 6 (16.7%) patients were not drained. The most frequently affected area is the submandibular area. (47.2%). Conclusion:We think that a successful response was obtained from empirical ampicillin sulbactam + clindamycin treatment.

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“…6 Department of Otorhinolaryngology-Head and Neck Surgery, Zhongshan People's Hospital, Zhongshan, Guangdong, People's Republic of China. 7 Department of Otorhinolaryngology-Head and Neck Surgery, First People's Hospital of Guangzhou, Guangzhou, Guangdong, People's Republic of China. 8 • support for research data, including large and complex data types • gold Open Access which fosters wider collaboration and increased citations maximum visibility for your research: over 100M website views per year…”

Section: Availability Of Data and Materialsmentioning

confidence: 99%

“…Considering that DNSA is typically a polymicrobial infection (e.g., coinfection with aerobic and anaerobic bacteria), most clinicians recommend the use of broadspectrum antibiotics as empiric treatment [2,[5][6][7]. However, using a narrow-spectrum antibiotic would reduce changes to the normal flora and adverse events, thereby limiting the overgrowth of resistant nosocomial organisms, avoiding the potential toxicity of multipledrug regimens, and reducing costs, which is in line with the goals of the antimicrobial stewardship program (ASP) in China [8,9].…”

Section: Introductionmentioning

confidence: 99%

Bacteriological analysis based on disease severity and clinical characteristics in patients with deep neck space abscess

et al. 2022

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Background Deep neck space abscess (DNSA) is a serious infection in the head and neck. Antibiotic therapy is an important treatment in patients with DNSA. However, the results of bacterial culture need at least 48 h, and the positive rate is only 30–50%, indicating that the use of empiric antibiotic treatment for most patients with DNSA should at least 48 h or even throughout the whole course of treatment. Thus, how to use empiric antibiotics has always been a problem for clinicians. This study analyzed the distribution of bacteria based on disease severity and clinical characteristics of DNSA patients, and provides bacteriological guidance for the empiric use of antibiotics. Methods We analyzed 433 patients with DNSA who were diagnosed and treated at nine medical centers in Guangdong Province between January 1, 2015, and December 31, 2020. A nomogram for disease severity (mild/severe) was constructed using least absolute shrinkage and selection operator–logistic regression analysis. Clinical characteristics for the Gram reaction of the strain were identified using multivariate analyses. Results 92 (21.2%) patients developed life-threatening complications. The nomogram for disease severity comprised of seven predictors. The area under the receiver operating characteristic curves of the nomogram in the training and validation cohorts were 0.951 and 0.931, respectively. In the mild cases, 43.2% (101/234) had positive culture results (49% for Gram-positive and 51% for Gram-negative strains). The positive rate of cultures in the patients with severe disease was 63% (58/92, 37.9% for Gram-positive, and 62.1% for Gram-negative strains). Diabetes mellitus was an independent predictor of Gram-negative strains in the mild disease group, whereas gas formation and trismus were independent predictors of Gram-positive strains in the severe disease group. The positivity rate of multidrug-resistant strains was higher in the severe disease group (12.1%) than in the mild disease group (1.0%) (P < 0.001). Metagenomic sequencing was helpful for the bacteriological diagnosis of DNSA by identifying anaerobic strains (83.3%). Conclusion We established a DNSA clinical severity prediction model and found some predictors for the type of Gram-staining strains in different disease severity cases. These results can help clinicians in effectively choosing an empiric antibiotic treatment.

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Diagnostic and therapeutic approaches in deep neck infections: an analysis of 74 consecutive patients

Cited by 12 publications

References 38 publications

Isolation of Mycoplasma salivarium in the empyema of a diabetic patient with deep neck infection and necrotizing mediastinitis: A case report

Isolation of Mycoplasma salivarium in the empyema of a diabetic patient with deep neck infection and necrotizing mediastinitis: A case report

Efficacy of Empirical Ampicillin Sulbactam + Clindamycin Treatment in Deep Neck Infections in Adults

Bacteriological analysis based on disease severity and clinical characteristics in patients with deep neck space abscess

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