Deep neck space infections in Adolescents

Adolescent deep neck space infection is an important pathology that often requires hospitalization for antimicrobial therapy. The aim of the study was to identify the inciting organisms and their resistance profiles in the adolescent population of patients with deep neck space infection. We performed a single-center cross-sectional retrospective analysis of patients between 10 and 16 years of age, with deep neck space infections. From the 319 cases of deep neck space infections that presented over the study period, nine patients met the criteria to be included in the study. The mean age being 11.8 years. The microbiology of the specimens revealed mainly Staphylococcus and Streptococcus species and in some patients microscopy and culture showed no predominant bacteria. There was an overall 86% resistance of organisms to penicillin and ampicillin but most organisms were sensitive to amoxicillin-clavulanic acid Deep neck space infections in adolescents can initially be managed with amoxicillin-clavulanic acid, source control and surgical drainage if required. Culture directed therapy can be initiated after microbiology results. The spaces involved are similar to adults with 44% of patients having deep neck abscess secondary odontogenic infection. The microbiology however is similar to that of children with Streptococcus and staphylococcus species being the most predominant.

Descending mediastinitis secondary to deep neck abscess in a healthy patient: Case report

Necrotizing descending mediastinitis is an emergency which can be fatal in most cases. 80% to 85% of patients who develop descending necrotizing mediastinitis are young, previously healthy persons. We present the case of a healthy patient who, after a neck abscess, developed descending necrotizing mediastinitis complicated by atypical interstitial pneumonia.

MICROBE PATTERN AND RISK FACTORS OF DEEP NECK ABSCESS PATIENTS IN ATMA JAYA HOSPITAL

Introduction: Deep neck abscess is a pus accumulation in the space and tissue of the cervical fascia caused by an infection and has the potential for several complications. Appropriate use of antibiotics can prevent these complications, but long culture time has been a main concern. Diabetes and oral hygiene are identified as commonly found risk factors for deep neck abscess. This study aims to analyze patients’ characteristics and the usage of antibiotics in treating deep neck abscess patients in Atma Jaya Hospital as well as assessing the effect of diabetes and oral hygiene as the causes for deep neck abscess. Methods: This was a cohort retrospective, descriptive analytic study. The samples were from 23 deep neck abscess patients undergoing treatment in Atma Jaya Hospital and met the inclusion and exclusion criteria. Chi square and Fisher exact test were used to determine the significance effect of diabetes and higiene oral in relation to deep neck abscess. Results: There were more male patients than female patients with age range 20-30 years old. Streptococcus viridans and Streptococcus pyogenes were the most common bacteria causing deep neck abscesses. Metronidazole, gentamicin and ceftriaxone were the most widely used antibiotics and it had shown great compatibility to fight against germs found in this disease. Statistical test results on the effect of oral hygiene oral to submandibular abscesses, peritonsillar, and Ludwig’s angina were p(AS)=0.605, p(AP)=1.000, and p(LA)=1.000, while of diabetes were p(AS)=0.685, p(AP)=0.657, and p(LA)=1.000. Conclusion: Deep neck abscess tends to occur in male patients of productive age. Metronidazole, gentamicin and ceftriaxone were the recommended empiric antibiotics. There was no significant relationship between oral hygiene and diabetes on the occurrence of deep neck abscesses.

Prevalence, morbidity and mortality of deep neck abscess in a tertiary hospital from Northwestern Mexico

BACKGROUND. Neck abscesses are defined as processes of infectious origin, which form a collection of purulent material through the deep planes of the neck, formed by fasciae. It may involve one or more spaces of the cervical region. In addition, they can be localized or disseminated and generate extremely serious and life-threatening complications.OBJECTIVE. To identify the prevalence of deep neck abscess in our tertiary hospital center.MATERIAL AND METHODS. A retrospective, analytical, observational, and cross-sectional study was carried out from January 2015 to May 2019. The data observed during the care of the patients with a diagnosis of deep neck abscess were collected from the clinical records. Descriptive statistics were performed, and the odd ratio was used for the risk probability analysis.RESULTS. A prevalence of 42 cases was found in 5 years, with 8.4 annual cases, average age of 45.2 years, male gender predominance in 53% of the cases. Descending mediastinitis was the most common complication and a mortality of 8.33% was presented. Type 2 diabetes mellitus and the involvement of 3 or more spaces represented a higher risk for complications compared to healthy patients who presented involvement of ≤2 spaces.CONCLUSION. In the Northwestern region of Mexico of IMSS beneficiaries, we have a prevalence of 42 cases in 5 years, 8.4 per year. The average age of our series is 45.2 years and there is no difference regarding the affection by gender. The involvement of two or more than three spaces represents the majority of cases. More than half of our cases underwent surgical drainage. Type 2 diabetes mellitus alone or accompanied with other comorbidities was the most common associated pathology; this same entity and the involvement of 3 or more spaces presented a higher risk of complications