Evaluation of deep neck infections in childhood

Abstract

Objective: Deep neck infections are characterized by infections in the potential spaces of the fascial planes of the neck. The objective of the study was to evaluate the characteristics of patients with deep neck infections who were admitted to pediatric infectious disease clinics.Materials and Methods: The data of patients with deep neck infection was analyzed retrospectively for demographic characteristics, clinical presentation, microbiological and radiological findings, complications, and outcomes between January 2010 and December 2014.Results: During the study period, a total of 18 patients diagnosed with deep neck infection were followed. Of these, 10 patients (55.6%) were male and the mean age was 84 +/- 60.5 months (18-192 months). The most common symptoms at presentation were neck mass (72%) and fever (67%). Three patients (16.6%) had peritonsillar, 7 (39%) had parapharyngeal, 7 (39%) had retropharyngeal, and 1 (5.4%) had parapharyngeal-retropharyngeal infection. Cefotaxime+clindamycin or cefotaxime+clindamycin+gentamicin were the most frequently (78%) used antibiotics. Eleven patients (61%) recovered with only antibiotic treatment. Surgical drainage was performed in 7 patients (39%) who were unresponsive to antibiotic treatment (5 with parapharyngeal, 1 with retropharyngeal, and 1 with peritonsillar abscess). Microorganisms were isolated from 6 (33%) patients' drainage samples. The median length of hospitalization was 14 (7-21) days. The mean duration of antibiotic treatment was 19.3 +/- 4.4 days. Acute glomerulonephritis developed in 1 patient with retropharyngeal abscesses. No recurrence/relapse or mortality was observed.Conclusion: Deep neck infections should be considered in the differential diagnosis of children who present with fever and neck mass. Most patients with deep neck infections can be treated with antibiotics; however, if there is no clinical improvement, surgical drainage must be performed immediately. (J Pediatr Inf 2015; 9: 114-21)