Management of pediatric lateral neck infections: Does the adage "... never let the sun go down on undrained pus ..." hold true?
OBJECTIVE
Pediatric neck infections are frequently treated by Otolaryngologists, Head and Neck surgeons. The relative role of medical versus surgical treatment of pediatric neck infections is debated. The aims of this study are to analyze the management of pediatric neck infections with respect to clinical assessment, radiological assessment and treatment.


METHODS
Medical records from January 1999 to June 2005 were reviewed and analyzed.


RESULTS
Two hundred and five children with lateral neck infections were included in the study. The clinical diagnosis correlated with the radiology finding in 73.6% with a sensitivity of 28% and a specificity of 92% for lateral neck abscess recognition. The ultrasound finding correlated with the surgical finding in 65.2% with a sensitivity of 70% and a specificity of 33%. When an ultrasound scan was used it changed the intended treatment plan in 10.5% of children.


CONCLUSIONS
Accurate clinical assessment of lateral neck infections is poor, generally under estimating suppuration. However, when an abscess is diagnosed clinically this correlates highly with the surgical finding. Radiological assessment has inaccuracy in identifying suppuration and this should be borne in mind when being used as a diagnostic tool for neck infections.
Courtney
Mark J
MJ
Department of Pediatric Otolaryngology, Head and Neck Surgery, Starship Hospital and University of Auckland, Auckland, New Zealand. courtneykids@yahoo.com
Miteff
Alex
A
Mahadevan
Murali
M
D000038:Abscess / Q000175:diagnosis* / Q000628:therapy*; D000293:Adolescent; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004322:Drainage; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008199:Lymphadenitis / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000188:drug therapy; D013211:Staphylococcus aureus / Q000302:isolation & purification; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D019980:Amoxicillin-Potassium Clavulanate Combination