title: Diagnosis and management of deep neck infections in children: the experience of an Italian paediatric centre.
abstract: Deep neck infection (DNI) is a severe occurrence in children. We've examined the presenting signs and symptoms, the value of single diagnostic procedures, the rate of complications and the impact of the therapeutic options on the final outcome, in children with a DNI. We retrospectively evaluated patients, aged 0-18 years, who were admitted for a DNI, from January 2006 through December 2012, at Regina Margherita Children's Hospital, Turin, Italy. We subdivided them on the basis of type of treatment: pharmacological treatment alone or antimicrobial treatment plus surgery. An univariate analysis has been performed to examine the differences between the two groups. Sixty patients (32 males, 28 females) with diagnosis of DNI were enrolled; 33 children only received medical treatment (group 1), whereas 27 patients underwent also surgical interventions (group 2). The mean abscess size was significantly higher in group 2 than in group 1 (p = 0.01). The predominant organisms were Streptococcus sp. (11 cases, 52.4%, mostly Streptococcus pyogenes). The most frequent antibiotic regimen was a β lactam alone (either III generation cephalosporin or amoxicillin/clavulanate). The duration of intravenous antibiotic varied between the two groups, without statistical significance (p = 0.052); whereas the oral antibiotic administration was significantly shorter in group 1 than in group 2 (p = 0.0003). Three patients (5%) developed complications. This research confirms that the medical approach, with high doses of intravenous antibiotics for a minimum of 5 days, could be a tolerable and safe option for the treatment of patients with stable condition and/or small DNIs.
authors.affiliation: Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy. Electronic address: ire_raffaldi@yahoo.it.
authors.forename: Irene
authors.initials: I
authors.lastname: Raffaldi
authors.affiliation: Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Le Serre
authors.affiliation: Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Garazzino
authors.affiliation: Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Scolfaro
authors.affiliation: Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy; Unit of Immunology and Infectious Diseases, University-Hospital Pediatric Department, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Bertaina
authors.affiliation: Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Mignone
authors.affiliation: Department of Paediatric Otolaryngology, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Peradotto
authors.affiliation: Department of Paediatric Otolaryngology, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Tavormina
authors.affiliation: Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy.
authors.forename: Pier-Angelo
authors.initials: PA
authors.lastname: Tovo
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D008297:Male; D009333:Neck / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic treatment; Children; Complications; Deep neck infections; Surgery