Lack of association of CT findings and surgical drainage in pediatric neck abscesses

Malloy, Kelly M.; Christenson, Thomas; Meyer, James S.; Tai, Steven; Deutsch, Ellen S.; Barth, Patrick; O’Reilly, Robert

doi:10.1016/j.ijporl.2007.10.016

Cited by 28 publications

(28 citation statements)

References 8 publications

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“…5A-C). Our results were similar to those previously published by Malloy et al [7]. Their study evaluated the association between CT finding and surgical drainage in pediatric neck abscesses.…”

Section: Discussionsupporting

confidence: 93%

Fluid Collections in Amputations Are Not Indicative or Predictive of Infection

Polfer

Hoyt

Senchak

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background In the acute postoperative period, fluid collections are common in lower extremity amputations. Whether these fluid collections increase the risk of infection is unknown. Questions/purposes The purposes of this study were to determine (1) the percentage of patients who develop postoperative fluid collections in posttraumatic amputations and the natural course of the collection; (2) whether patients who develop these collections are at increased risk for infection; and to ask (3) are there objective clinical or radiologic signs that are associated with likelihood of infection when a fluid collection is present?Methods We performed a review of all 300 patients injured in combat operations who sustained at least one major lower extremity amputation (at or proximal to the tibiotalar joint) and were treated definitively at our institution between March 2005 and April 2009. We segregated the groups based on whether cross-sectional imaging was performed less than 3 months (early group) after closure, greater than 3 months (late group) after closure, or not at all (control group, baseline frequency of infection). Our primary study cohort where those patients with a fluid collection in the first three months. The clinical course was reviewed and the primary outcome was a return to the operating room for irrigation and débridement with positive cultures. For those patients with cross-sectional imaging, we also collected objective clinical parameters within 24 hours of the scan (white blood cell count, maximum temperature, presence of bacteremia, tachycardia, oxygen desaturation), extremity examination (presence of erythema, warmth, and/or drainage), and characteristics of the fluid collections seen (size of the fluid collection, Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Section: Discussionsupporting

confidence: 93%

Fluid Collections in Amputations Are Not Indicative or Predictive of Infection

Polfer

Hoyt

Senchak

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…RPA predominantly occurs in 4-year-old boys, during winter, following an episode of upper respiratory tract infection [4,5,[7][8][9][13][14][15][16][17][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

“…In other hand, follow-up imaging should be performed in the absence of clinical improvement after initiation of parenteral antibiotic therapy [3][4][5]7,9,[13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

“…Surgical drainage is considered on symptoms, biological and CTscan datas [3][4][5][10][11][12][13][14][15][16][17][18]. Except in case of complications, time of emergency drainage is debated.…”

Section: Discussionmentioning

confidence: 99%

“…RPA usually occurs during winter and, for an unknown reason, predominantly affects boys [3,6,[8][9][10][11][12][13][14][15][16][17]. The diagnosis and management of RPA remain difficult for paediatricians, radiologists and otorhinolaryngologists, as RPA can be mistaken for epiglottitis [4,18].…”

Section: Introductionmentioning

confidence: 99%

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Contribution of CT scan and CT-guided aspiration in the management of retropharyngeal abscess in children based on a series of 18 cases

Martin

Gabrillargues

Louvrier

et al. 2014

European Annals of Otorhinolaryngology, Head and Neck Diseases

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Contrast-enhanced neck CT scan confirmed the diagnosis of retropharyngeal abscess and the indication for surgical drainage. It must be performed urgently, on admission. When it is decided to treat the patient with antibiotics alone, follow-up imaging should be performed in the absence of improvement 24 to 48 hours after starting antibiotics. CT-guided percutaneous aspiration is both a diagnostic modality confirming abscess formation of an inflammatory lesion of the retropharyngeal space as well as a therapeutic tool, sometimes avoiding the need for surgical drainage.

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