Deep neck infections in children – approach to diagnosis and treatment
Authors:
Klára Perce; Kateřina Sobotková; Milan Urík; Michal Jurajda; Anna Vravcová; Jana Šťastná; Denisa Pavlovská
Authors‘ workplace:
Klinika dětské otorhinolaryngologie LF MU a FN Brno
Published in:
Otorinolaryngol Foniatr, 73, 2024, No. 2, pp. 81-90.
Category:
Original Article
doi:
https://doi.org/10.48095/ccorl202481
Overview
Introduction: In the treatment of deep throat infections, it is necessary to make a correct decision about surgical treatment. The aim was to observe trends and characteristics of patients requiring surgical treatment and to identify factors that predict the type of treatment. Materials and methods: This is a retrospective study including pediatric patients hospitalized in the Children‘s Hospital of The University Hospital Brno with deep throat infections between 2010–2019. Studied parameters: age, sex, duration of problems before hospitalization, presence of dysphagia, odynophagia, impaired neck mobility, bulging of the pharyngeal wall, ankylostomia, respiratory problems, dysphonia, drooling, cervical lymphadenitis, sore throat, length of hospitalization, conservative or surgical approach, and well-being day. Laboratory investigations included CRP, neutrophil granulocyte count, and microbiological findings. Imaging examinations monitored the presence of phlegm or abscess, side, position relative to the great vessels and oppression of the great vessels, and size of abscess. Results: This study presents the clinical characteristics of 78 deep throat infections. Observed trends: patients with abscesses were younger, had higher CRP, and were hospitalized longer. Larger abscess statistically resulted in surgical treatment. Patients with phlegm had a shorter time to achieve comprehensive improvement. The incidence of an abscess is not related to gender. Boys had statistically significantly higher CRP and neutrophil granulocyte counts. The most common microbiological finding was Streptococcus pyogenes. Conclusion: Patients with abscesses were younger, had longer hospital stays, and had higher CRP.
Keywords:
abscess – deep neck infection – children
Sources
1. Srba A, Fundová P, Kovář D et al. Hluboké krční záněty – diagnostika a terapie. Otorinolaryngol Foniatr 2017; 66 (2): 86–91.
2. Chrobok V, Komínek P, Plzák J et al. Otorinolaryngologie a chirurgie hlavy a krku. Havlíčkův Brod: Tobiáš 2022.
3. Šlapák I, Urík M, Bezděková D et al. Dětská otorinolaryngologie. Praha: Mladá fronta 2019.
4. Wetmore RF, Muntz HR, McGill Tj et al. Pediatric otolaryngology. Principles and practice pathways. New York: Thieme 2000.
5. Zeleník K, Komínek P, Matoušek P et al. Retrofaryngeální absces. Pediatr pro Prax 2007; 8 (6): 389–390.
6. Mungul S, Maharaj S. Microbiology of paediatric deep neck space infection. Int J Pediatr Otorhinolaryngol 2019; 123: 116–122. Doi: 10.1016/j.ijporl.2019.04.042.
7. Krtičková J, Haviger J, Ryšková L et al. Hluboké krční záněty jako komplikace zánětu hltanu (retrospektivní studie). Otorinolaryngol Foniatr 2017; 66 (1): 7–11.
8. Woods CR, Cash ED, Smith AM et al. Retropharyngeal and Parapharyngeal Abscesses Among Children and Adolescents in the United States: Epidemiology and Management Trends, 2003–2012. J Pediatric Infect Dis Soc 2015; 5 (3): 259–268. Doi: 10.1093/jpids/piv 010.
9. Maharaj S, Mungul S, Ahmed S. Deep Neck Space Infections: Changing Trends in Pediatric Versus Adult Patients. J Oral Maxillofac Surg 2020; 78 (3): 394–399. Doi: 10.1016/ j.joms.2019.11.028.
10. Velhonoja J, Laaveri M, Soukka T et al. Early surgical intervention enhances recovery of severe pediatric deep neck infection patients. Int J Pediatr Otorhinolaryngol 2021; 144: 110694. Doi: 10.1016/j.ijporl.2021.110 694.
11. Huang CM, Huang FL, Chien YL et al. Deep neck infections in children. J Microbiol Immunol Infect 2017; 50 (5): 627–633. Doi: 10.1016/j.jmii.2015.08.020.
12. Virbalas J, Friedman NR. Impact of neck CT on the management of suspected pediatric deep neck space infection. Int J Pediatr Otorhinolaryngol 2021; 147: 110782. Doi: 10.1016/ j.ijporl.2021.110782.
13. Sousa Menezes A, Ribeiro DC, Guimaraes JR et al. Management of pediatric peritonsillar and deep neck infections – cross-sectional retrospective analysis. World J Otorhinolaryngol Head Neck Surg 2019; 5 (4): 207–214. Doi: 10.1016/j.wjorl.2019.04.003.
14. Quinn NA, Olson JA, Meier JD et al. Pediatric lateral neck infections – Computed tomography vs ultrasound on initial evaluation. Int J Pediatr Otorhinolaryngol 2018; 109: 149–153. Doi: 10.1016/j.ijporl.2018.04.001.
15. Penton M jr, Oraa SS, Abdelhemid A et al. Head and neck infections in children due to Eikenella corrodens: Report of three cases and review of literature. Int J Pediatr Otorhinolaryngol 2020; 138: 110287. Doi: 10.1016/ j.ijporl.2020.110287.
ORCID autorů
Přijato k recenzi: 13. 11. 2023
Přijato k tisku: 18. 1. 2024
MUDr. Klára Perce, Ph.D.
Klinika dětské otorhinolaryngologie
LF MU a FN Brno
Černopolní 212/9
613 00 Brno
perce.klara@fnbrno.cz
Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
![Issue 2](https://www.prolekare.cz/media/cache/resolve/journal_issue/media/image_pdf/4554e3391bacf1a7a5e37119e5021dcc.jpg)
2024 Issue 2
Most read in this issue
- Change in anticoagulation therapy prescription in relation to severe epistaxis
- Deep neck infections in children – approach to diagnosis and treatment
- Aphagia as a symptom of Fahr’s syndrome – case study
- Treatment of presbyphonia with lipoinjection of vocal cords – a case report