title: Complications in pediatric deep neck space abscesses.
abstract: OBJECTIVE
  To determine the incidence and demographic profile of children who develop complications from deep neck space abscess.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Tertiary children's hospital.
  
  
  METHODS
  One hundred thirty-eight patients admitted for deep neck space abscesses between 1998 and 2008. Inclusion criteria were age younger than 18 years and computed tomography scan demonstrating an abscess in the retropharyngeal, parapharyngeal, or peritonsillar spaces. Children were diagnosed with abscess if purulence was encountered on operative incision and drainage.
  
  
  RESULTS
  In the first 5 years of the study, 45 children met the inclusion criteria, whereas in the latter 5 years, 93 children were treated for abscesses. There were no differences between these cohorts in terms of age (P = .70), gender (P = .08), abscess site (P = .23), or rate of surgical intervention (P = .83). The total major complication rate was 9.4% (n = 13) with mediastinitis being the most frequent (n = 9) complication. The number of complications between the first (n = 3) and second (n = 10) groups was not significantly different (P = .55). The factors that predisposed patients to develop complications were younger age at presentation and retropharyngeal abscess location. Children with complications were more likely to have Staphylococcus aureus identified as the causative organism (P = .007). Only 1 of 4 children with methicillin-resistant S aureus had a complicated clinical course.
  
  
  CONCLUSIONS
  Deep neck space abscesses continue to cause significant morbidity in children. Factors that predict complications include young age, retropharyngeal location, and S aureus. Providers must maintain a high index of suspicion to promptly diagnose and treat these complications.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Children's Hospital of King's Daughters, Norfolk, Virginia 23507, USA. baldassc@yahoo.com
authors.forename: Cristina M
authors.initials: CM
authors.lastname: Baldassari
authors.forename: Rebecca
authors.initials: R
authors.lastname: Howell
authors.forename: Melissa
authors.initials: M
authors.lastname: Amorn
authors.forename: Ross
authors.initials: R
authors.lastname: Budacki
authors.forename: Sukgi
authors.initials: S
authors.lastname: Choi
authors.forename: Maria
authors.initials: M
authors.lastname: Pena
mesh_terms: D000038:Abscess / Q000150:complications* / Q000000981:diagnostic imaging / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008480:Mediastinitis / Q000209:etiology; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D009333:Neck; D017703:Retropharyngeal Abscess / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology; D014057:Tomography, X-Ray Computed