Rational Diagnostic and Therapeutic Management of Deep Neck Infections: Analysis of 233 Consecutive Cases

Abstract

It is worth emphasizing that airway support is the priority in patients with deep neck infections. Empirical antibiotic treatments must cover gram-positive and gram-negative aerobic and anaerobic pathogens. Surgical exploration and drainage may be mandatory in selected cases at presentation or in cases that fail to respond to parenteral antibiotics within the first 24 to 48 hours. It is important to perform cultures during operation to establish the pathogen(s) involved and to obtain an antibiogram to tailor the antibiotic treatment.

Clinical and epidemiological profile of deep neck space infections: A retrospective study in Hamadan, Western Iran, during 2008-2013

“…In our cases, upper airway obstruction was the most common complication followed by septic shock and mediastinitis. In this study three patients had septic shock and one of them died, for a fatality rate of 33.3% which was obviously higher than what Boscolo-Rizzo had reported with fatality rate of 4.5% for septic shock (15). Overall mortality rate in our study was 0.49% which is acceptable and reflects rapid diagnosis, efficient medical treatment and appropriate surgical interventions.…”

The relationship between high incidence of deep neck infection and toothbrushing frequency

“…According to a recent study (Fujita et al, 2009) lower frequency of daily tooth brushing was related to higher prevalences of diabetes mellitus, hypertension and high triglyceride (TG) and/or low high density lipoprotein cholesterol (HDL-C). Similarly, recently published most reports indicated obviously that odontogenic infections comprise the most common cause of DNSI (Bakir et al, 2012;Kinzer et al, 2009;Marioni et al, 2010).…”

“…Tel: 00904122488101, 00905414520412. Fax: 00904122488100. et al, 2012;Kinzer et al, 2009;Marioni et al, 2010).…”

Our approach to deep neck abscesses of dental origin

“…[3][4][5] Özellikle diş sorunu olan hastalarda onkolojik tedaviye (radyoterapi/kemoterapi) başlamadan bu sorunların çözümlenmesi komplikasyon gelişimini önleyebilmektedir. Bizim diş kökenli boyun apsesi saptadığımız hastaların birinde diyabet, birinde hipertansiyon ve diyabet, birinde de kronik böbrek hastalığı gibi komorbid hastalıklar vardı.…”

“…Enfeksiyonun erken evrelerinde belirtiler göz ardı edilebilmektedir. [2,3] Hastalarda sıklıkla ağrı, ateş, trismus ve boyun hareketlerinde kısıtlılık gibi semptomlar görülebilmektedir. Bu çalışmada diş kökenli derin boyun apsesi gelişen hastalara yaklaşımımız değerlendirildi.…”