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Pediatric Deep Neck Infections: Does Age Matter?

Shany Havazelet1,2, Tara Coreanu1,2, Tali Klein2

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|November 6, 2025
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Summary
This summary is machine-generated.

Pediatric deep neck infections (DNIs) present differently by age, but outcomes are similar. Age-specific guidelines are needed for diagnosis and treatment to optimize care for children.

Keywords:
abscessdeep neck infectionsparapharyngealretropharyngealsurgical drainage

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Area of Science:

  • Pediatric Otolaryngology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Pediatric deep neck infections (DNIs) present diagnostic and therapeutic challenges.
  • Current management lacks age-specific guidelines despite anatomical and clinical differences.
  • Age-related variations in presentation, imaging, treatment, and outcomes require evaluation.

Purpose of the Study:

  • To evaluate age-related variations in pediatric deep neck infections (DNIs).
  • To assess implications for modifying existing management algorithms.
  • To compare clinical presentation, imaging use, treatment approach, and outcomes across pediatric age groups.

Main Methods:

  • Retrospective analysis of 268 pediatric patients with retropharyngeal or parapharyngeal infections (2009-2020).
  • Patients stratified into three age groups: <1 year, 1-6 years, and >6 years.
  • Comparison of clinical features, imaging, treatment, and outcomes; multivariate logistic regression for predictors of surgical drainage and prolonged hospitalization.

Main Results:

  • Retropharyngeal infections more common in children under 6; parapharyngeal infections more common in those over 6.
  • Infants presented with nonspecific symptoms; older children had localized signs.
  • Computed tomography (CT) scan was the strongest predictor for surgical drainage (P < 0.001); age did not significantly influence surgical rates or hospitalization length. Overall surgical drainage rate was 7.8%.

Conclusions:

  • Pediatric deep neck infections (DNIs) show distinct age-related patterns in presentation and infection site.
  • Outcomes for pediatric DNIs remain consistent across age groups.
  • Age-specific clinical algorithms are needed for diagnostic imaging and intervention thresholds to optimize pediatric care.