Deep neck infection in children.
OBJECTIVE
Deep neck infection is a potentially life-threatening disease and rarely seen in children. Because of the obscure complaints and symptoms, the diagnosis of deep neck infection may be delayed, which may result in inappropriate treatment. This retrospective study was aimed at analyzing the occurrence of complications, diagnostic methods and proper managements of deep neck infection in children.


METHODS
A retrospective study was performed on 30 children with deep neck infection treated from October 1999 through October 2003. The etiology, clinical symptoms, laboratory examination, radiological examination, bacteriology, and treatments were retrospectively analyzed.


RESULTS
The most common predisposing factors were tonsillitis and upper respiratory tract infection. The most common symptoms were fever (93.3%) and painful swelling of the neck (70.0%). Both peritonsillar (24.3%) and parapharyngeal space infections (24.3%) were the most common, followed by submandibular space infections (18.9%). The most common pathogens isolated were Staphylococcus aureus (27.3%) and viridans streptococci (22.7%). The mean duration of hospitalization was 7.9 days, with a range from 2 to 18 days. Complications occurred in 2 patients, including recurrence and pulmonary edema.


CONCLUSIONS
Deep neck infection should be suspected in a child who presents with fever and painful swelling of the neck. Staphylococcus aureus and viridans streptococci were the most common pathogens. Computed tomography scan should be performed in time and infections in peritonsillar and ,parapharyngeal spaces were the most common.
Liu
Chun-Hsin
CH
Department of Otolaryngology, China Medical University Hospital, Taichung, Taiwan. reliu0524@yahoo.com.tw
Lin
Chia-Der
CD
Cheng
Yuan-Kai
YK
Lin
Hsiao-Chuan
HC
Tsai
Ming-Hsui
MH
D000293:Adolescent; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001420:Bacteria, Aerobic / Q000187:drug effects / Q000302:isolation & purification; D001421:Bacteria, Anaerobic / Q000187:drug effects / Q000302:isolation & purification; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D007709:Klebsiella / Q000187:drug effects / Q000302:isolation & purification; D009333:Neck / Q000473:pathology*; D009343:Neisseria / Q000187:drug effects / Q000302:isolation & purification; D011549:Pseudomonas / Q000187:drug effects / Q000302:isolation & purification; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D034363:Viridans Streptococci / Q000187:drug effects / Q000302:isolation & purification
D000900:Anti-Bacterial Agents