Deep Neck Abscesses in Children: An Italian Retrospective Study

Area of Science:

• Pediatric infectious diseases
• Otolaryngology
• Surgical infections

Background:

• Retropharyngeal and parapharyngeal abscesses (RPAs, PPAs) are common in young children.
• Current treatment lacks specific guidelines, necessitating appropriate diagnosis and management to prevent complications.

Purpose of the Study:

• To review the diagnosis and management of pediatric RPAs/PPAs.
• To compare surgical versus medical treatment approaches for these deep neck infections.

Main Methods:

• A multicenter retrospective study of children under 15 years with RPAs/PPAs from 2008-2016.
• Inclusion criteria based on International Classification of Diseases, Ninth Revision codes.
• Data collected on patient demographics, symptoms, diagnostic imaging, bacterial cultures, and treatment outcomes.

Main Results:

• 153 children were included; median age 4.4 years, male predominance.
• Common symptoms included fever, neck pain, and stiff neck; diverse bacteria were cultured.
• 56.9% underwent surgery, 43.1% received antibiotics alone; no severe complications reported.
• Predictors for surgery included abscess size (>3 cm), high white blood cell count, and hospital of admission.

Conclusions:

• Deep neck abscesses in children present with nonspecific symptoms and variable management.
• Standardized protocols are essential for consistent care and improved patient outcomes in managing pediatric RPAs/PPAs.