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Deep neck infections in different age groups of children
Lung Chang1, Hsin Chi, Nan-Chang Chiu
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
Insights
Deep neck infections (DNIs) in children vary by age, with retropharyngeal abscesses common in younger children and peritonsillar abscesses in adolescents. Early detection of DNIs is crucial due to potential complications.
Area of Science:
- Pediatric Infectious Diseases
- Otolaryngology
- Head and Neck Surgery
Background:
- Deep neck infections (DNIs) pose significant morbidity risks in pediatric populations.
- Understanding the age-related patterns of DNIs is crucial for effective management.
Purpose of the Study:
- To analyze the clinical presentations, diagnostic indicators, and age-specific relationships of deep neck infections in pediatric patients.
- To identify variations in DNI location based on age groups.
Main Methods:
- Retrospective review of pediatric patients diagnosed with DNIs between January 1996 and December 2007.
- Categorization of infections by anatomical space (peritonsillar, parapharyngeal, retropharyngeal) and age (children <10 years, adolescents 10-18 years).
Main Results:
- Fifty patients were analyzed; retropharyngeal abscesses occurred exclusively in children, while peritonsillar abscesses were more common in adolescents (81%).
- Fever and neck masses were common in retropharyngeal and parapharyngeal abscesses; odynophagia was prevalent in peritonsillar abscesses.
- Complications included airway obstruction and mediastinitis. Recurrent DNIs were noted in six patients.
Conclusions:
- The anatomical location of deep neck infections in children is age-dependent.
- The insidious nature and potential for severe complications necessitate vigilant examination in children presenting with fever and neck masses, particularly younger children.
Background/Purpose:
Deep neck infections (DNIs) can cause significant morbidity in children. This study analyzes the clinical presentations, diagnostic clues, and age relationship of DNI in pediatric patients.
Methods:
Pediatric patients admitted to our hospital from January 1996 to December 2007 with a diagnosis of DNIs were reviewed retrospectively. Diseases were categorized according to the site of infection: peritonsillar, parapharyngeal, and retropharyngeal spaces. Patients were divided into two groups: children (aged < 10 years) and adolescents (aged 10-18 years).
Results:
Fifty pediatric patients were enrolled, including nine with DNI in the retropharyngeal space, 17 in the parapharyngeal, 21 in the peritonsillar and three with mixed type abscesses. A total of 21 patients belonged to the child group, and 29 were adolescents. All retropharyngeal abscesses occurred in children; whereas most peritonsillar abscesses (81%) were found in adolescents. Most retropharyngeal and parapharyngeal abscesses were associated with fever (100% and 65%, respectively) and neck masses (67% and 94%, respectively); while odynophagia was the most common symptom in peritonsillar abscess (100%). Thirty-two abscess cultures were obtained and seven grew mixed pathogens, followed by Streptococcus pyogenes (n = 5), and normal flora (n = 5). Complications of airway obstruction arose in one patient with parapharyngeal abscess, and mediastinitis in another two patients with retropharyngeal abscesses. Recurrent DNIs were observed in six patients; three had congenital bronchogenic cysts.
Conclusion:
The location of the DNI appears to vary in different pediatric age groups. Its insidious presentation, with a potentially complicated course, warrants careful inspection in children with fever and neck masses, especially young children.
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