A multicentre observational study of paediatric head and neck abscesses

Area of Science:

• Otolaryngology
• Infectious Diseases
• Paediatric Surgery

Background:

• Paediatric ENT surgeons noted a higher incidence of severe head and neck abscesses in winter 2022/23.
• A UK-wide data evaluation was initiated to confirm this trend and identify associated factors.

Purpose of the Study:

• To determine if there was a true increase in paediatric head and neck abscesses in the UK during winter 2022/23.
• To identify factors associated with observed changes in abscess incidence and severity.

Main Methods:

• A multicentre retrospective data collection from 13 UK units.
• Inclusion of patients with head and neck abscesses (sinogenic, otogenic, deep/superficial neck) admitted between September 2022 and February 2023.
• Analysis of demographic, disease-specific, management, and outcome data, alongside historical hospital episode statistics.

Main Results:

• 262 patients admitted with head and neck abscesses; mastoid abscesses were most common.
• Significant rise in Group A Streptococcus (GAS) positive cultures from 12% (autumn) to 30% (winter), p=0.02.
• Increased rates of intracranial complications (10% to 18%) and venous thrombosis (3% to 14%, p=0.01) during winter.

Conclusions:

• A statistically significant increase in GAS-associated head and neck abscesses was observed between autumn and winter 2022/23.
• A significant rise in venous thromboses associated with head and neck abscesses occurred during the same period.
• Despite perceived increases, overall paediatric head and neck abscess incidence aligned with pre-COVID-19 trends.