Peritonsillar and deep neck infections: a review of 330 cases

Pascual, Paula Martínez; Martínez, Paloma Pinacho; Friedlander, Eviatar; Oviedo, Carlos Martín; Yurrita, Bartolomé Scola

doi:10.1016/j.bjorl.2017.03.008

Cited by 22 publications

(11 citation statements)

References 21 publications

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“…As expected, pharyngalgia, odynophagia, and trismus were the most common reported symptoms, corroborated by the literature [1,3,16]. Regardless of its frequency, trismus continues to be a "gray" pathognomonic indication.…”

Section: Discussionsupporting

confidence: 74%

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Ubi pus, ibi evacua: a review of 601 peritonsillar abscess adult cases

et al. 2021

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Background Peritonsillar abscess (PTA) is the most common deep neck infection, occurring as a consequence of bacterial acute tonsillitis or as a result of infection of the Weber glands, with frequent and life-threatening complications. Aim To investigate several factors associated with complications and worse prognosis, such as defining the method of surgical drainage and treatment of a PTA which remains an area of controversy in the literature Methods The purpose of this retrospective study is to examine the epidemiological, clinical, and laboratory findings of 601 adult patients and to discuss them along with their treatment plan. Results Pharyngalgia was the most common reported symptom, followed by trismus, odynophagia, fever, hot potato voice, malaise, and cervical lymphadenopathy. Sixty-eight patients developed complications. Streptococcus species were the most common pathogens. A statistically significant difference was found in days of hospitalization, WBC and CRP levels, age, and the pre-existing systemic diseases between patients with and without complications. A comparison of patients treated with intravenous and oral antibiotics revealed no statistically significant difference. Conclusion Οver 10% of PTA cases may develop complications, the most common of which is extension into deep neck spaces. Comorbid conditions increase the risk of complications. Despite the wide range of treatment strategies, incision and drainage remain the cornerstone of surgical treatment. In patients with no comorbidities, intravenous antibiotics appear to have no advantage over oral antibiotics.

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Section: Discussionsupporting

confidence: 74%

“…Numerous studies have established a link between the prevalence and severity of PTA and comorbidities. According to Martínez Pascual et al, systemic comorbidities are associated with a worse prognosis in patients undergoing PTA [16]. Wu et al found a link between diabetes mellitus type 2 and an increased risk of PTA [18].…”

Section: Discussionmentioning

confidence: 99%

Ubi pus, ibi evacua: a review of 601 peritonsillar abscess adult cases

et al. 2021

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“…The smoking rate of the patients in our study was 47.7% and this rate was higher than the smoking rate (30.5%) in the Turkish population reported by Özer et al ( 9) (Table 1). In addition, it is stated in the literature that the average length of stay in the hospital of the patients varies between 5 and 8 days (2,10). Also in our study, the average length of stay was 6 days.…”

Section: Discussionsupporting

confidence: 61%

“…DNSI often occurs in potential spaces of the neck such as the submandibular region, peritonsillar region, parapharyngeal or retropharyngeal space, and masticator space (6). Martínez et al (10) reported that 65.2% of the patients had infection located in the peritonsillar region and 0.9% in the submandibular region. Buckley et al (8) stated that infection was located in the parapharyngeal region at the rate of 60%.…”

Section: Discussionmentioning

confidence: 99%

Deep Neck Space Infection: Clinical Outcomes of Patients Treated in a Tertiary Care Center

Kaya¹,

Yağcı²,

Doğan³

et al. 2021

hamidiyemedj

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Background: Deep neck space infection (DNSI) is a suppurative infection of the visceral cavities of the neck, which usually begins in the form of fasciitis and progresses to abscess formation. Immediate evaluation and management of deep neck space infections is imperative. Materials and Methods:A total of 109 patients who were hospitalized and treated in our ear, nose and throat clinic with the diagnosis of DNSI were included in the study. No age or gender restrictions were made. Patient charts were analyzed retrospectively, and information about demographic characteristics of the patients, complaints at presentation and time of admission, location, antibiotics that were used in treatment, duration of hospitalization and complications were recorded.Results: In our study, 60.6% of the patients were male and the mean age was 31 years (3.5 months-103 years). It was observed that the most frequent admissions to our clinic were in the months of April and January. The most common anatomical locations of infection and abscess were the submandibular region and level 2 in neck, respectively. The most common complaint at presentation was pain (92%), 47.7% of the patients (52) developed DNSI on the right side, and microorganism growth was reported in 52% of 48 patients whose culture results could be reached, and in 32% of these patients (8/25) Staphylococcus spp. and in 20% (5/25) M. tuberculosis growth was observed. The average age of the patients who required multiple antibiotics was found to be significantly higher. Conclusion:Although M. tuberculosis is not frequently encountered as a causative microorganism in the literature, it was determined as the second most frequently encountered agent in our study and it is an important factor that should be considered. In addition, three important steps in the management of DNSI patients are; ensuring airway safety, appropriate antibiotherapy and surgical drainage. These crucial steps are very important in terms of protection from complications.

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“…[3] DNSIs can lead to potentially fatal complications including mediastinitis, septic shock, jugular vein thrombosis, and airway obstruction. [45] Therefore, timely intervention is crucial. Diabetes, HIV immunosuppression, alcoholism, and drug abuse predispose to the development of complications.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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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.

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Peritonsillar and deep neck infections: a review of 330 cases

Abstract: Systemic comorbidities are bad prognosis predictors. Nowadays mortality has decreased thanks to multidisciplinary attention and improvements in diagnosis and treatment.

Cited by 22 publications

References 21 publications

Ubi pus, ibi evacua: a review of 601 peritonsillar abscess adult cases

Ubi pus, ibi evacua: a review of 601 peritonsillar abscess adult cases

Deep Neck Space Infection: Clinical Outcomes of Patients Treated in a Tertiary Care Center

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

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