Pediatric deep neck infections: efficacy of conservative treatment versus immediate surgical intervention

Year 2017, Volume: 7 Issue: 2, 94 - 98, 30.09.2017

Emel Tahir , Nilda Süslü R. Önder Günaydın Oğuz Kuşçu Onur Ergün Umut Akyol

Abstract

Objective: The objective of this study was
to review the management of deep neck space infections in pediatric
patients and to evaluate the efficacy of intravenous antibiotic
treatment alone before surgical drainage, and also to point out the
indications for the drainage.




Methods: We
reviewed sixty pediatric cases who were treated in our clinic because of
deep neck space infections. The details of demographic data, medical
history, initial complaints and physical examination, radiological
examination, microbiology and laboratory results (C-reactive protein
level and leukocyte count), treatment modality and follow-up findings
were collected. The bacteriological results, management, complications,
follow-up data and outcomes were also noted. A basic treatment algorithm
for the management of the pediatric deep neck space infections was
constituted.




Results: In
47 (78.3%) of the children, infection did not require any surgical
intervention or puncture - in other words, needle aspiration - and it
was successfully treated with antibiotic therapy alone. Fifty-six
patients (93%) were initially treated with sulbactam-ampicillin.




Conclusion: We
advise surgical drainage in cases of fluctuating large abscesses and
infections without clinical improvement despite antibiotic treatment,
and in complicated or life-threatening cases such as retropharyngeal
abscess and mediastinitis. An otolaryngologist should be patient before
any surgical intervention.

Keywords

Deep neck infection, children, antibiotic treatment, surgery, Derin boyun enfeksiyonu, çocuklar, antibiyotik tedavisi, cerrahi

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