Related Experiment Videos
Complications in pediatric deep neck space abscesses
Cristina M Baldassari1, Rebecca Howell, Melissa Amorn
1Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Children's Hospital of King's Daughters, Norfolk, Virginia 23507, USA. baldassc@yahoo.com
Insights
Deep neck space abscesses in children are increasingly common. Younger age, retropharyngeal location, and Staphylococcus aureus infection increase complication risk, necessitating prompt diagnosis and treatment.
Area of Science:
- Pediatric Otolaryngology
- Infectious Diseases in Children
- Surgical Complications
Background:
- Deep neck space abscesses (DNSA) are serious infections in children.
- Understanding the incidence and risk factors for complications is crucial for pediatric care.
Purpose of the Study:
- To determine the incidence and demographic profile of children experiencing complications from deep neck space abscesses.
- To identify factors predicting the development of complications in pediatric DNSA.
Main Methods:
- A retrospective case series was conducted at a tertiary children's hospital.
- One hundred thirty-eight pediatric patients (age < 18) with confirmed deep neck space abscesses were analyzed.
- Inclusion criteria included CT-demonstrated abscess and purulence on drainage.
Main Results:
- The incidence of DNSA increased over the study period (1998-2008).
- The overall major complication rate was 9.4%, with mediastinitis being most frequent.
- Younger age, retropharyngeal abscess location, and Staphylococcus aureus were associated with increased complications.
Conclusions:
- Deep neck space abscesses remain a significant cause of morbidity in children.
- Early identification of high-risk factors (young age, retropharyngeal site, S. aureus) aids in predicting complications.
- Prompt diagnosis and management are essential to reduce pediatric morbidity from DNSA.
Objectives:
To determine the incidence and demographic profile of children who develop complications from deep neck space abscess.
Study Design:
Case series.
Setting:
Tertiary children's hospital.
Subjects And Methods:
One hundred thirty-eight patients admitted for deep neck space abscesses between 1998 and 2008. Inclusion criteria were age younger than 18 years and computed tomography scan demonstrating an abscess in the retropharyngeal, parapharyngeal, or peritonsillar spaces. Children were diagnosed with abscess if purulence was encountered on operative incision and drainage.
Results:
In the first 5 years of the study, 45 children met the inclusion criteria, whereas in the latter 5 years, 93 children were treated for abscesses. There were no differences between these cohorts in terms of age (P = .70), gender (P = .08), abscess site (P = .23), or rate of surgical intervention (P = .83). The total major complication rate was 9.4% (n = 13) with mediastinitis being the most frequent (n = 9) complication. The number of complications between the first (n = 3) and second (n = 10) groups was not significantly different (P = .55). The factors that predisposed patients to develop complications were younger age at presentation and retropharyngeal abscess location. Children with complications were more likely to have Staphylococcus aureus identified as the causative organism (P = .007). Only 1 of 4 children with methicillin-resistant S aureus had a complicated clinical course.
Conclusions:
Deep neck space abscesses continue to cause significant morbidity in children. Factors that predict complications include young age, retropharyngeal location, and S aureus. Providers must maintain a high index of suspicion to promptly diagnose and treat these complications.
Related Concept Videos
01:26Brain Abscess l: Introduction
01:30Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
01:26Tonsillitis II: Management
01:30Pneumonia III: Complications and Assessment
01:22Bacterial Meningitis I: Introduction
01:28Acute Pyelonephritis II: Diagnostic Studies and Management