scholarly journals The role of sepsis screening, SIRS and qSOFA in Head and Neck Infections: An Audit of 104 Patients

2021 ◽  
Author(s):  
Zain Sheikh ◽  
E Tian Tan ◽  
Sunday Ifedayo ◽  
Shahed Quraishi
Keyword(s):  
Head And Neck ◽  
Sepsis Screening ◽  
Head And Neck Infections

scholarly journals The role of screening, SIRS and qSOFA in Head and Neck Sepsis: An Audit of 104 Patients

2020 ◽  
Author(s):  
Zain Sheikh ◽  
E Tian Tan ◽  
Sunday Ifedayo ◽  
Quraishi M Shahed
Keyword(s):  
Head And Neck ◽  
General Hospital ◽  
District General Hospital ◽  
High Morbidity ◽  
Key Points ◽  
Patients At Risk ◽  
Sepsis Screening ◽  
Visual Reminders ◽  
Head And Neck Infections

Key Points • Sepsis is associated with high morbidity and mortality and is a known complication of infections of the head and neck. Screening for sepsis should be conducted on admission in order to identify patients at risk and provide early intervention. • Our audit on an ENT ward in a district general hospital found that sepsis screening is poor, however this can be improved further by education and visual reminders such as poster or a clerking proforma. • The most common head and neck infections admitted to a district general hospital were tonsillitis, peritonsillar cellulitis and peritonsillar abscesses. • The incidence of sepsis as a complication of head and neck infections is very rare if diagnosed according to the updated qSOFA criteria. • Using SIRS criteria may result in falsely high rates of diagnosis of sepsis and may lead to excessive and inappropriate clinical management in patients who could otherwise be managed less aggressively.

scholarly journals Evaluating the Role of Staphylococcus aureus Nasal PCR in Pediatric Head and Neck Infections

2021 ◽  
Vol 26 (7) ◽  
pp. 734-739
Author(s):  
Chandni Patel ◽  
Guru Bhoojhawon ◽  
Lukasz Weiner ◽  
Danelle Wilson ◽  
Derek Zhorne ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Treatment Failure ◽  
Head And Neck ◽  
Pediatric Patients ◽  
Total Duration ◽  
Kidney Injury ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Head And Neck Infections

OBJECTIVE Vancomycin is often empirically used in the management of head and neck infections (HNIs) in children. The objective of this study was to determine the utility of Staphylococcus aureus (SA) nasal PCR to facilitate de-escalation of vancomycin for pediatric HNIs. METHODS This was a single-center, retrospective cohort study of pediatric patients who received empiric intravenous vancomycin for a diagnosis of HNIs between January 2010 and December 2019. Subjects were excluded if they met any of the following: confirmed/suspected coinfection of another site, dialysis, immunocompromised status, admission to the NICU, alternative diagnosis that did not require antibiotics, or readmission for HNIs within 30 days of previous admission. The primary outcome was time to de-escalation of vancomycin. Total duration of antibiotics, treatment failure, hospital length of stay (LOS), and incidence of acute kidney injury (AKI) were also assessed. RESULTS Of the 575 patients identified, 124 patients received an SA nasal PCR. The median time to de-escalation was 39.5 hours in those patients compared with 53.7 hours in patients who did not have a SA nasal PCR (p = 0.002). No difference was noted in total duration of all methicillin-resistant Staphylococcus aureus antibiotics, hospital LOS, treatment failure, and AKI. CONCLUSIONS In a large cohort of pediatric patients with HNIs, those who underwent testing with an SA nasal PCR spent less time receiving intravenous vancomycin, although their LOS was not significantly reduced. Further investigation is needed to better define the role of SA nasal PCRs in determining antibiotic therapy for HNIs.

Indium 111–Labeled Leukocyte Scintigraphy in Evaluating Head and Neck Infections

1992 ◽  
Vol 101 (12) ◽  
pp. 961-968 ◽  
Author(s):  
Jeffrey S. Epstein ◽  
Lawrence Grobman ◽  
William I. Ganz ◽  
W. Jarrard Goodwin ◽  
Mark Lizak ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Cell ◽  
Head And Neck ◽  
Radionuclide Imaging ◽  
Imaging Tool ◽  
Leukocyte Scintigraphy ◽  
Indium 111 ◽  
Gallium 67 ◽  
Head And Neck Infections

This retrospective study looked at the role of indium 111-labeled white blood cell (111In WBC) scintigraphy in head and neck infections. The efficacy of 111In WBCs was compared to gallium 67 citrate (67Ga) and technetium Tc99m methylene diphosphonate (99mTc MDP) scintigraphy in detecting and monitoring the resolution of infection. For 22 active infections, the sensitivities for 111In WBC, 67Ga, and 99mTc MDP scintigraphy were 94%, 56%, and 86%, respectively, and the specificities for 111In WBC, 67Ga, and 99mTc MDP scintigraphy were 100%, 43%, and 0%, respectively. For 8 successfully treated infections, all seven 111In WBC studies became negative after therapy, in as short an interval as 1 month. In contrast, all seven 99mTc MDP images remained positive for as long as 6 months after therapy. The seven 67Ga studies had variable results, with four (57%) remaining positive, including two (28%) positive at 6 months after therapy. These results suggest that 111In WBC scintigraphy should be the initial radionuclide imaging tool in detecting active head and neck infections because of its greater accuracy, and its ability to revert to normal much sooner than 67Ga or 99mTc MDP scintigraphs when applied to a subset of patients with resolved infections.

Anaerobic Infections in Otolaryngology

1981 ◽  
Vol 90 (3_suppl2) ◽  
pp. 13-16 ◽  
Author(s):  
Sydney M. Finegold
Keyword(s):  
Respiratory Tract ◽  
Head And Neck ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Anaerobic Infections ◽  
Head And Neck Infections

The role of anaerobes in head and neck infections is discussed. Data from several key studies are presented. It is emphasized that the source of anaerobic organisms in otolaryngological infections is the indigenous flora of the upper respiratory tract.

Role of methicillin-resistant Staphylococcus aureus in head and neck infections

2009 ◽  
Vol 123 (12) ◽  
pp. 1301-1307 ◽  
Author(s):  
I Brook
Keyword(s):  
Staphylococcus Aureus ◽  
Head And Neck ◽  
Retropharyngeal Abscess ◽  
Therapeutic Approaches ◽  
Cervical Lymphadenitis ◽  
Methicillin Resistant ◽  
The Past ◽  
Aerobic And Anaerobic ◽  
Head And Neck Infections

AbstractThe prevalence of infection with methicillin-resistant Staphylococcus aureus is increasing. Methicillin-resistant Staphylococcus aureus is also being recognised as an important pathogen in head and neck infections. This review summarises studies published over the past two decades which illustrate the growing prevalence of methicillin-resistant Staphylococcus aureus, and the current therapeutic approaches to head and neck infections caused by this bacterium. These infections include sinusitis, otitis, periorbital cellulitis, cervical lymphadenitis, tonsillitis, thyroiditis, retropharyngeal abscess, and abscesses and wounds of the neck. Treatment of head and neck infections associated with methicillin-resistant Staphylococcus aureus includes drainage and debridement, as well as administration of local and systemic antimicrobials that provide coverage against these organisms and against potential aerobic and anaerobic pathogens that may be present if the infection is polymicrobial.

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