A Clinical Study of the Deep Neck Infections in Children

Yang, Yoon Soo; Lee, Hwa Uk; Lee, Sang Heon; Hong, Ki Hwan

Abstract

BACKGROUND AND OBJECTIVES
The objective of this study was to clarify the presenting signs and symptoms, clinical course, pathologic organisms, and management of deep neck infections in children. SUBJECTS AND METHOD: We retrospectively reviewed the in-patient charts of children treated at our ENT department for deep neck infections. Thirty-six such patients were identified as having been treated from January 2000 to December 2003. RESULTS: During the 4-year period, 36 children with deep neck space infection were diagnosed and treated, including 20 (56%) boys and 16 (44%) girls. The ages ranged from 11 months to 15 years, with the mean of 6.9+/-4.5 years. The most common site of infection was the peritonsillar space (41.7%), followed by the parapharyngeal (27.8%) and submandibular (16.6%) space. Six (16.6%) children had infections in more than one fascial space. The most commonly known associated preceding illness was viral upper respiratory infection (53%). Neck swelling, fever, and dysphagia were the most frequent symptoms. The most common pathogens were Streptococcus pyogens (3/10) and Staphylococcus aureus (2/10). The mean duration of hospitalization was 7.7 days (range, 2-15). Leukocytosis (WBC>15000/mm3) was found in 13 (36%) patients. All patients received parenteral antibiotics after admission. Thirteen (36%) children recovered from the infection with conservative treatment and twenty-three (64%) children received surgical drainage. No complication and tracheotomy occurred. CONCLUSION: Deep neck space infections in children are rapidly progressive and usually present with neck swelling and fever. Peritonsillar space and Streptococcus pyogens infections were most common anatomic sites and pathogen in deep neck infection of children, respectively.