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Age-, site-, and time-specific differences in pediatric deep neck abscesses.

James M Coticchia1, Geoffrey S Getnick, Romy D Yun

  • 1Department of Otolaryngology, Wayne State University, Detroit, MI 48201, USA. jcoticch@med.wayne.edu

Archives of Otolaryngology--Head & Neck Surgery
|February 18, 2004
PubMed
Summary

Deep neck abscesses in children present differently based on age. Younger children show S. aureus infections in anterior/submandibular regions, while older children have S. aureus or GAS in deeper neck spaces.

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Area of Science:

  • Pediatric Infectious Diseases
  • Otolaryngology
  • Surgical Pathology

Background:

  • Deep neck abscesses are serious infections in children.
  • Understanding age-specific presentations, causative organisms, and anatomical locations is crucial for effective management.

Purpose of the Study:

  • To delineate the clinical presentations, microbial etiology, and anatomical sites of deep neck abscesses in pediatric patients.
  • To identify age-related differences in these characteristics.

Main Methods:

  • Retrospective review of 169 pediatric patients surgically treated for deep neck abscesses between 1989 and 1999.
  • Analysis of patient demographics, clinical signs, symptoms, causative organisms, and abscess locations.

Main Results:

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  • Common symptoms across all ages included neck mass, fever, and cervical adenopathy.
  • Children under 4 years exhibited more agitation, cough, rhinorrhea, and respiratory distress compared to older children.
  • Staphylococcus aureus was the predominant pathogen in children under 1 year, while Group A Streptococcus was more common in older children. Abscess locations varied significantly by age group.

Conclusions:

  • Deep neck abscesses in infants (<1 year) are often located in anterior/submandibular regions and caused by S. aureus.
  • In older children (≥1 year), abscesses commonly involve retropharyngeal/parapharyngeal spaces and are frequently caused by Group A Streptococcus.