Deep Neck Abscesses in Children An Italian Retrospective Study

被引：7

作者：

Dona, Daniele ^{[1
]}

Gastaldi, Andrea ^{[2
]}

Campagna, Marta ^{[2
]}

Montagnani, Carlotta ^{[3
]}

Galli, Luisa ^{[3
,4
]}

Trapani, Sandra ^{[3
]}

Pierossi, Nicola ^{[3
]}

De Luca, Maia ^{[5
]}

D'Argenio, Patrizia ^{[5
]}

Tucci, Filippo Maria ^{[6
]}

De Vincentiis, Giovanni ^{[6
]}

Grotto, Paolo ^{[7
]}

Da Mosto, Maria Cristina ^{[8
,9
]}

Frigo, Anna Chiara ^{[10
]}

Volo, Tiziana ^{[11
]}

Emanuelli, Enzo ^{[11
]}

Martini, Alessandro ^{[11
]}

Da Dalt, Liviana ^{[2
]}

机构：

[1] Univ Padua, Div Pediat Infect Dis, Padua, Italy

[2] Univ Padua, Dept Woman & Child Hlth, Pediat Emergency Dept, Via Giustiniani 3, I-35141 Padua, Italy

[3] Anna Meyer Childrens Univ Hosp, Pediat Infect Dis Unit, Florence, Italy

[4] Univ Florence, Dept Hlth Sci, Florence, Italy

[5] Bambino Gesu Pediat Hosp, Univ Dept Pediat, Unit Immune & Infect Dis, Rome, Italy

[6] Bambino Gesu Pediat Hosp, Res Inst, Unit Otolaryngol Head & Neck Surg, Rome, Italy

[7] S Maria Ca Foncello, Div Pediat, Treviso, Italy

[8] Univ Padua, Dept Neurosci, Sect Otolaryngol, Padua, Italy

[9] Reg Ctr Head & Neck Canc, Treviso, Italy

[10] Univ Padua, Biostat Epidemiol & Publ Hlth Unit, Dept Cardiac Thorac & Vasc Sci, Padua, Italy

[11] Univ Padua, Dept Otolaryngol & Endoscop Surg Upper Airways, Padua, Italy

来源：

PEDIATRIC EMERGENCY CARE | 2021年 / 37卷 / 12期

关键词：

deep neck infections; parapharyngeal abscess; retropharyngeal abscess; UPPER RESPIRATORY-TRACT; ANTIBACTERIAL DRUG-USE; RETROPHARYNGEAL ABSCESS; PARAPHARYNGEAL INFECTIONS; CONSERVATIVE TREATMENT; SPACE INFECTIONS; MANAGEMENT; HEAD; PERITONSILLAR; MICROBIOLOGY;

D O I：

10.1097/PEC.0000000000002037

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: Retropharyngeal and parapharyngeal abscesses (RPAs, PPAs) usually affect young children. Surgical drainage and/or antibiotic therapy are treatment of choice, but no specific guidelines exist. In order to reduce the risk of severe complications, appropriate diagnosis and therapy are necessary. The aims of the study were to review diagnosis and management of children with RPAs/PPAs and to compare surgical versus medical approach. Methods: This is a multicenter retrospective study including all patients younger than 15 years admitted at 4 Italian pediatric hospitals of Florence, Padua, Rome, and Treviso, with International Classification of Diseases, Ninth Revision discharge diagnosis code of RPAs and PPAs, from January 1, 2008, to December 31, 2016. Results: One hundred fifty-three children were included. The median age was 4.4 years, with overall male predominance. Heterogeneous signs and symptoms (fever, neck cervical, lymphadenopathy, pain, and stiff neck most frequently) and a large mixture of bacteria from pus cultures were detected. Computer tomography (66.7%) and magnetic resonance imaging (27.5%) were performed to confirm the presence of abscess. Fifty-one percent of abscesses were greater than 3 cm. Eighty-seven patients (56.9%) underwent surgery, and 66 (43.1%) were treated with antibiotics alone (mostly ceftriax-one, metronidazole, amikacin, and clindamycin) with median days of therapy of 26.5 days and length of therapy of 16.0 days of median. Median length of stay was 11 days. None had severe complications. Multivariate analysis indicated as independent predictive factors of surgery abscess of 3 cm or greater, high white blood cell count, and-most of all-the hospital of admission. Conclusions: Deep neck abscesses mostly affect patients in early childhood, with a combination of nonspecific signs and symptoms, and it still emerges as a heterogeneous approach in diagnosis and management of these infections. Thus, common shared protocols represent an essential tool in order to standardize care and improve patients' outcomes.

引用

页码：E1358 / E1365

页数：8

共 46 条

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