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Deep neck infections in children
Insights
Deep neck infections in children are most common in the retropharyngeal space, often caused by multiple bacteria. Most children recover fully, but complications can occur.
Area of Science:
- Pediatric Infectious Diseases
- Otolaryngology
- Microbiology
Background:
- Deep neck infection (DNI) is a serious condition in children.
- Understanding the epidemiology and common pathogens is crucial for effective treatment.
Purpose of the Study:
- To investigate the clinical characteristics, pathogens, and outcomes of deep neck infections in Taiwanese children.
- To identify risk factors and common sites of infection.
Main Methods:
- Retrospective study of 68 children with deep neck infection from December 1989 to 1998.
- Analysis of patient demographics, clinical presentation, causative pathogens, treatment, and outcomes.
Main Results:
- The most common infection site was the retropharyngeal space (36.7%).
- Fever, neck pain, and swelling were primary symptoms. Viridans streptococci and Staphylococcus aureus were the most frequent pathogens.
- Polymicrobial infections occurred in 46% of cases. Mean hospitalization was 12.4 days, with 89.7% achieving complete resolution.
Conclusions:
- Retropharyngeal space infections and polymicrobial infections are prevalent in Taiwanese children.
- Prompt diagnosis and appropriate antibiotic therapy are essential for managing deep neck infections and preventing complications.
Abstract:
From December 1989 through 1998, a total of 68 children with deep neck infection were enrolled into this study. The mean age was 5.9 years (range, 1 month-15.8 years). Infections in the retropharyngeal space (36.7%) were most common, followed by parapharyngeal space (30.8%), peritonsillar space (20.6%), and submandibular space (11.9%). Fever, neck pain, and swelling were the most frequent symptoms. The most common pathogens were viridans streptococci (41%, 16/39) and Staphylococcus aureus (26%, 10/39). Other isolates included Prevotella spp., Veillonella spp., Klebsiella pneumoniae, Escherichia coli, Morganella spp., and Enterobacter spp. Mixed infection was found in 46% (18/39) of patients. The mean duration of hospitalization was 12.4 days (range, 2-45 days). Complete resolution was achieved in 61 (89.7%) children. Complications occurred in 7 patients, including recurrence, mediastinal spread, bacteremia, and suppurative thyroiditis; the patient with mediastinal spread plus bacteremia died. Five patients had congenital cyst and 4 of them had complications or recurrence/relapse. In conclusion, infections in the retropharyngeal space and polymicrobial infections were most common in deep neck infection of Taiwan children.