Çocuklarda Derin Boyun Enfeksiyonları: Klinik Bulgular ve Tedavi Kararını Belirleyen Faktörler

Öz

Pediatrik derin boyun enfeksiyonları (DBE), hızlı ilerleyebilmesi ve ciddi komplikasyonlara yol açabilmesi nedeniyle klinik açıdan önemlidir. Bu çalışmada, pediatrik DBE’lerin klinik, radyolojik ve mikrobiyolojik özelliklerini değerlendirmek ve C-reaktif protein–albumin–lenfosit (CALLY) indeksinin cerrahi drenaj gereksinimi ve klinik prognoz ile ilişkisini araştırmak amaçlandı. 2021–2025 tarihleri arasında derin boyun enfeksiyonu tanısıyla yatırılarak tedavi edilen 1–17 yaş arası 99 pediatrik hasta retrospektif olarak incelendi. Demografik veriler, klinik bulgular, görüntüleme sonuçları, laboratuvar parametreleri, mikrobiyolojik kültürler, antibiyotik tedavileri ve cerrahi girişimler kaydedildi. CALLY indeksi, nötrofil-lenfosit oranı (NLR) ve trombosit-lenfosit oranı (PLR) hastaneye yatışta alınan ilk kan örneklerinden hesaplandı. Hastaların ortalama yaşı 7,9 ± 4,7 yıl olup %59,6’sına cerrahi drenaj uygulandı. Drenaj yapılan grupta apse boyutları anlamlı olarak daha büyüktü (p < 0,001). Yaş, hastanede yatış süresi, CRP, NLR, PLR ve CALLY indeksi açısından drenaj yapılan ve yapılmayan gruplar arasında anlamlı fark saptanmadı (p> 0,05). Kültür pozitif hastalarda en sık izole edilen patojenler Streptococcus türleri ve Staphylococcus aureus idi. Sonuç olarak, pediatrik derin boyun enfeksiyonlarında cerrahi karar sürecinde apse boyutu en güvenilir belirleyici olmaya devam etmektedir. CALLY indeksi ve diğer inflamasyona dayalı indekslerin cerrahi drenaj gereksinimi ve prognozu öngörmedeki katkısı sınırlıdır.

Anahtar Kelimeler

• Derin boyun enfeksiyonu
• abse
• inflamatuar indeks
• pediatrik

Deep Neck Infections in Children: Clinical Presentation and Determinants of Treatment Decisions

Öz

Pediatric deep neck infections (DNIs) are clinically significant conditions due to their potential for rapid progression and serious complications. This study aimed to evaluate the clinical, radiological, and microbiological characteristics of pediatric DNIs and to investigate the association between the C-reactive protein–albumin–lymphocyte (CALLY) index and the need for surgical drainage and clinical outcomes. This retrospective study included 99 pediatric patients aged 1–17 years who were hospitalized with deep neck infections between 2021 and 2025. Demographic data, clinical presentation, imaging findings, laboratory parameters, microbiological results, antibiotic therapy, and surgical interventions were reviewed. The CALLY index, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were calculated using blood samples obtained at hospital admission. The mean age was 7.9 ± 4.7 years, and surgical drainage was performed in 59.6% of patients. Abscess dimensions were significantly larger in the drainage group (p < 0.001). No significant differences were observed between drainage and non-drainage groups regarding age, length of hospital stay, CRP, NLR, PLR, or CALLY index (all p > 0.05). Among culture-positive cases, Streptococcus species and Staphylococcus aureus were the most frequently isolated pathogens. In conclusion, abscess size remains the most reliable factor guiding surgical decision-making in pediatric deep neck infections. Inflammation-based indices, including the CALLY index, showed limited value in predicting surgical drainage or clinical prognosis.

Anahtar Kelimeler

• Deep neck infection
• Abscess
• Inflammation-based index
• Pediatric

Kaynakça

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