title: Children with deep space neck infections: our experience with 178 children.
abstract: OBJECTIVE
  To identify clinical features associated with unsuccessful medical therapy in children with deep space neck infections (DSNIs).
  
  
  METHODS
  Consecutive case series with chart review.
  
  
  METHODS
  Tertiary-care, academic children's hospital.
  
  
  METHODS
  One hundred seventy-eight pediatric patients treated for retropharyngeal or parapharyngeal infections between July 1, 2007, and May 23, 2012.
  
  
  RESULTS
  Median age was 34.5 months (2.9 years; range, 2-142 months); two-thirds were male. Increased surgical drainage was found in children age ≤ 15 months (P = .002) and for abscesses >2.2 cm (P = .0001). Risk factors associated with increased likelihood of medical therapy failure included age ≤ 51 months, intensive care unit admission, and computed tomography findings consistent with abscess size >2.2 cm. Methicillin-resistant Staphylococcus aureus infections were found more often in younger children, with the highest incidence in those ≤ 15 months of age (P = .001). All children had resolution of infection.
  
  
  CONCLUSIONS
  Deep space neck infections in children can often be successfully managed with medical therapy alone, but life-threatening complications may occur. We recommend that young patients be managed cautiously.
authors.affiliation: Division of Pediatric Otolaryngology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. chengj1@email.chop.edu
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Cheng
authors.forename: Lisa
authors.initials: L
authors.lastname: Elden
mesh_terms: D000046:Academic Medical Centers; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D009333:Neck / Q000503:physiopathology; D010608:Pharyngeal Diseases / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D012008:Recurrence; D017703:Retropharyngeal Abscess / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: deep space neck infection; parapharyngeal infection; pediatric; retropharyngeal infection