Paediatric neck abscesses: microbiology and management.
BACKGROUND
Paediatric neck abscesses remain common problems which are sometimes difficult to manage.


METHODS
We conducted a retrospective study of 64 children who underwent incision and drainage of neck abscesses at Leeds General Infirmary from 1 February 2002 to 31 July 2006. The aim of this study was to identify the presenting symptoms in children, the appropriateness of prescribed antibiotics and the role of atypical mycobacteria in neck infections. The outcome measure was clinical resolution of the abscess.


RESULTS
The mean presenting age was 44.2 months (3.68 years). The commonest sign and symptom was neck mass (96.9 per cent). The mean period of hospitalisation was 3.7 (+/- standard deviation of 1.9) days. Staphylococcus aureus (48.4 per cent) was the commonest organism cultured. Atypical mycobacteria were found in only 4.7 per cent of the specimens. Flucloxacillin was the most common antibiotic used (57.8 per cent), often in combination with other antimicrobials. The abscess recurrence rate was 4.7 per cent. No fatalities occurred in this series of patients.


CONCLUSIONS
Appropriately prescribed intravenous antibiotics and surgical drainage remain the central core of treatment. Atypical mycobacterial infection is an important differential diagnosis of a painless, cervico-facial mass. An algorithm for the management of paediatric neck abscesses is proposed.
Rustom
I K
IK
Department of Otolaryngology, Head and Neck Surgery, Leeds General Infirmary, UK. isamrustom@hotmail.com
Sandoe
J A T
JA
Makura
Z G G
ZG
D000038:Abscess / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009333:Neck / Q000382:microbiology* / Q000601:surgery; D012189:Retrospective Studies; D013223:Statistics as Topic
D000900:Anti-Bacterial Agents