Presentation, diagnosis and management of neck abscesses in children

Kurzyna, Agnieszka; Gościk, Elżbieta; Goździewski, Artur; Skotnicka, Bożena; Hassmann‐Poznańska, Elżbieta

doi:10.5604/00306657.1172740

Cited by 2 publications

(7 citation statements)

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“…We found 23 studies reporting 1453 patients ( Fig 1 , Table 1 ) [ 8 – 30 ]. Two of the studies (9%) were prospective, whereas 20 studies (87%) were retrospective, and one study did not report the study design.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the effects of morphological properties of the abscess on PPV, 9 studies (39%) reported on rim enhancement ( Table 2 ) [ 8 , 14 , 16 , 18 , 19 , 21 , 24 , 26 , 30 ], and 10 studies (43%) reported on abscess diameter [ 8 , 10 , 12 , 14 , 16 , 19 , 21 , 22 , 24 , 26 ]. The meta-regression analysis found no overall effect of the moderators (CT criteria for an abscess, size of collection, rim enhancement, pediatric patients, or publication age) (p = 0.306).…”

Section: Resultsmentioning

confidence: 99%

“…Although publication bias was not evident in the funnel plot, studies with smaller sample sizes tended to show larger variation in PPV. For example, the five studies including more than 90 patients all have PPV in the range of 0.78–0.85 [ 8 – 12 ], whereas studies with less than 70 patients have a wider range of 0.67–0.97 [ 16 – 30 ]. We found evidence for considerable heterogeneity across the studies.…”

Section: Discussionmentioning

confidence: 99%

“…Complete rim enhancement in late stages of abscess formation may explain some of the false negatives [ 28 , 29 ]. Indeed, complete rim enhancement has been reported to be present in 42–82% (average 61%) of patients with surgically confirmed abscesses [ 14 , 16 , 21 , 26 , 30 ] ( Table 2 ). Overall, on average 88% of patients with surgically confirmed abscesses have been reported to present either partial or complete rim enhancement on CT ( Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…Seven studies reported rim enhancement in 14–100% of surgically confirmed non-purulent collections. On average, these studies reported 64% of non-purulent collections to have rim enhancement, although it is unclear whether these presented partial or complete enhancement [ 8 , 14 , 16 , 18 , 19 , 26 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic accuracy of contrast-enhanced CT for neck abscesses: A systematic review and meta-analysis of positive predictive value

Hagelberg

Pape²,

Heikkinen³

et al. 2022

PLoS ONE

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Objectives To review the diagnostic accuracy of contrast-enhanced computed tomography (CT) in differentiating abscesses from cellulitis in patients with neck infections, using surgical findings as the reference standard. Materials and methods Previous studies in the last 32 years were searched from PubMed and Embase. Because of partial verification bias (only positive abscess findings are usually verified surgically), sensitivity and specificity estimates are unreliable, and we focused on positive predictive value (PPV). For all studies, PPV was calculated as the proportion of true positives out of all positives on imaging. To estimate pooled PPV, we used both the median with an interquartile range and a model-based estimate. For narrative purposes, we reviewed the utility of common morphological CT criteria for abscesses, such as central hypodensity, the size of the collection, bulging, rim enhancement, and presence of air, as well as sensitivity and specificity values reported by the original reports. Results 23 studies were found reporting 1453 patients, 14 studies in children (771 patients), two in adults (137 patients), and seven including all ages (545 patients). PPV ranged from 0.67 to 0.97 in individual studies, had a median of 0.84 (0.79–0.87), and a model-based pooled estimate of 0.83 (95% confidence interval 0.80–0.85). Most morphological CT criteria had considerable overlap between abscesses and cellulitis. Conclusions The pooled estimate of PPV is 0.83 for diagnosing neck abscesses with CT. False positives may be due to limited soft tissue contrast resolution. Overall, none of the morphological criteria seem to be highly accurate for differentiation between abscess and cellulitis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Diagnostic accuracy of contrast-enhanced CT for neck abscesses: A systematic review and meta-analysis of positive predictive value

Hagelberg

Pape²,

Heikkinen³

et al. 2022

PLoS ONE

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Towards an understanding of the pathological basis of senile depression and incident dementia: Implications for treatment

Kawakami

Iga

Takahashi

et al. 2022

Psychiatry Clin Neurosci

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Senile depression (SD) is a heterogeneous syndrome. Several clinical profiles are more likely to appear in SD than in early-life depression, but it remains unclear whether the pathophysiology is different. The prevalence of dementia increases with aging, and the underlying pathophysiological processes in the preclinical phase begin even before cognitive deficits or neurological signs appear. SD may be either a risk factor for developing dementia or a prodromal stage of dementia. The inconsistent findings regarding the association between SD and incident dementia may be attributable to the neuropathological heterogeneity underlying SD. Most studies have focused on patients with the clinical diagnosis of Alzheimer disease (AD) as an outcome, but several clinicopathological studies suggest that primary age-related tauopathy and argyrophilic grain disease may account for a proportion of cases clinically misdiagnosed as AD in the elderly population. Furthermore, most AD cases have additional neuropathologic changes such as cerebrovascular disease and Lewy body disease. Here, we review the neuropathological findings linking SD to incident dementia, focusing on common age-related neuropathologies. In particular, the roles of disturbance of neural circuity, imbalance of monoaminergic systems, dysregulation of the hypothalamic-pituitary-adrenal axis, and elevated neuroinflammatory status are discussed. Finally, we review the current treatment of SD in the context of agerelated neuropathological changes.

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Presentation, diagnosis and management of neck abscesses in children

Cited by 2 publications

References 0 publications

Diagnostic accuracy of contrast-enhanced CT for neck abscesses: A systematic review and meta-analysis of positive predictive value

Diagnostic accuracy of contrast-enhanced CT for neck abscesses: A systematic review and meta-analysis of positive predictive value

Towards an understanding of the pathological basis of senile depression and incident dementia: Implications for treatment

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