Related Experiment Video
Updated: Oct 8, 2025
Assessment of the Efficacy of An Osteopathic Treatment in Infants with Biomechanical Impairments to Suckling
Published on: February 5, 2019
Pediatric deep neck infections: Clinical description and analysis of therapeutic management
N Demongeot1, M Akkari2, C Blanchet2
1Department of Pediatrics, University Hospital Arnaud de Villeneuve, University of Montpellier, France.
Insights
Exclusive medical treatment for acute pharyngeal suppuration shows high success rates, especially for smaller collections. Close monitoring is advised for patients with larger collections (≥15 mm) receiving initial antibiotic therapy.
Area of Science:
- Pediatric Infectious Diseases
- Otolaryngology
- Microbiology
Background:
- Acute pharyngeal suppuration is a significant concern in pediatric healthcare.
- Understanding clinical presentations and treatment outcomes is crucial for effective management.
- Identifying predictors for successful non-surgical intervention is a key clinical challenge.
Purpose of the Study:
- To detail clinical features, bacteriology, and treatment strategies for pediatric acute pharyngeal suppuration.
- To pinpoint clinical, bacteriological, and radiological indicators predicting successful exclusive medical management.
Main Methods:
- Retrospective analysis of 83 pediatric patients hospitalized for acute pharyngeal suppuration (2015-2017).
- Patients categorized into three groups: exclusive intravenous antibiotics (Group A), delayed surgery after antibiotics (Group B), and immediate surgery with antibiotics (Group C).
- Comparison of variables including age, neutrophil counts, collection diameter, antibiotic duration, and hospitalization length.
Main Results:
- Streptococcus pyogenes was the most common pathogen.
- Surgically treated patients (Group C) had significantly larger initial collections (27.89 mm) than those treated medically (Group A, 18.73 mm).
- Collections ≥15 mm required surgery even after 48 hours of antibiotics (Group B); hospitalization duration did not differ significantly between groups.
Conclusions:
- Exclusive medical treatment demonstrates a high cure rate, particularly for smaller pharyngeal collections.
- Patients with initial collections ≥15 mm receiving exclusive intravenous antibiotics require careful monitoring.
- Early surgical intervention may be beneficial for larger collections to ensure optimal outcomes.
Objectives:
The aim of our study was to describe clinical presentations, bacteriological results, and therapeutic management in a pediatric population presenting with acute pharyngeal suppuration. A further aim was to identify clinical, bacteriological, and radiological predictors of success associated with exclusive medical treatment.
Method:
A retrospective study was carried out including patients under 18 years of age hospitalized between January 1, 2015 and December 31, 2017 in our center for acute pharyngeal suppuration. We identified three groups of patients: group A, treated with exclusive intravenous antibiotics; group B, surgically treated after 48 h of appropriate antibiotic therapy, due to persistent fever and/or clinical worsening and/or persistence of a collection on follow-up imaging; group C, surgically treated as first-line therapy in association with intravenous antibiotics. A total of 83 patients were included: 36 in group A, 12 in group B, and 35 in group C. These three groups were compared for several variables: age of the patients, polynuclear neutrophil counts, diameter of the collections (the largest diameter found on imaging), duration of antibiotic therapy, delay before return to apyrexia, and hospitalization duration.
Results:
A neck mass and torticollis were present, respectively, in 48.8 and 47.6% of cases. No breathing difficulties were reported. Streptococcus pyogenes was the most frequently identified microorganism. The average diameter of the collections from patients treated surgically as first-line therapy (group C) was significantly larger than that of the patients treated with antibiotics (group A) (27.89 mm vs. 18.73 mm, respectively, p = 0.0006). All the patients who required surgery despite 48 h of appropriate antibiotic therapy (group B) had collections with diameters greater than or equal to 15 mm. There was no significant difference between the groups concerning hospitalization duration.
Conclusion:
Exclusive medical treatment is associated with a high cure rate, mainly for collections with small diameter. We recommend special attention to patients treated with first-line exclusive intravenous antibiotic therapy and with a collection diameter greater than or equal to 15 mm.
Related Concept Videos
01:26Tonsillitis II: Management
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:30Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.