Management of deep neck space infections in a tertiary center in North West Nigeria

Abstract

Background:Deep neck space infection (DNSI) is a potentially fatal condition that more commonly results from dental and tonsillar infections. Timely intervention is, therefore, crucial when such patients present to the managing physician.Objective:The objective of this study is to review the etiology, clinical presentation, and treatment outcome of patients managed for DNSIs over a period of 7 years at National Ear Care Centre, Kaduna.Methodology:The record of patients managed for DNSIs over a 7-year period between January 2010 and December 2016 was reviewed. Data obtained included demographic characteristics such as age, sex, occupation, level of education, main presenting symptoms, duration of symptoms, etiology of the DNSI, location of the infection, comorbidity, bacteriology, duration of hospital stay, and type of treatment given. The data were analyzed using the Statistical Package of the Social Sciences version 23.0.Results:A total of 55 patients presented with DNSIs, and there were 34 (61.8%) females and 21 (38.2%) males, with a sex ratio of 1.6:1. The age range of the patients was 1–71 years, with a mean age of 30.7 years (standard deviation of 18.1). The most common etiologic factor among these patients was tonsillar-related infection which accounted for 24 (43.6%). The most common symptom at presentation was fever (96.4%), followed by odynophagia (60%). Peritonsillar space infection as seen in 25 (45.5%) patients was the most common region affected, followed by submandibular space infection. Of the 35 (64%) patients who had incision and drainage, Staphylococcus aureus was the most common organism isolated in 16 (45.7%), followed by Streptococcus pneumoniae (11, 31.4%). Majority (38, 69.1%) of the patients spent <5 days on admission.Conclusion:This study shows that oropharyngeal and orodental infections are the most common causes of DNSIs. Educating the populace about orodental health may help in reducing cases of DNSIs in Nigeria.

Infections in the maxillofacial region in the clinic material – retrospective analysis

“…In our case, mostly male patients were predominant to the DNI (about 1.8:1) and other authors also suggest male predominance [1,8,9]. Age range in our study was between 21 up to 92 years with the average of 45 years that is also supported by different publications [1,10].…”

“…Pediatric patients are not referred to our department, that is why the mean age is higher than in publications that also included children [9].…”

Ultrasound-guided puncture drainage versus surgical incision drainage for deep neck space abscesses: a protocol for a systematic review with meta-analysis and trial sequential analysis

“…5 However, DNAs remain serious, spread rapidly and are associated with lifethreatening complications. [6][7][8][9] Common and potentially life-threatening complications range from 15% to 35% in patients with DNAs, 5 10 11 including airway compromise, descending mediastinitis, pericarditis, pneumonia, pleural empyema, carotid arterial erosion, meningitis, sepsis, respiratory distress, jugular vein thrombosis, disseminated intravascular coagulation and extracranial or intracranial extension of infection. 5 8-13 Therefore, the early detection of abscesses and thorough treatment are crucial.…”