Early surgical intervention enhances recovery of severe pediatric deep neck infection patients

xloma.fota.13 shared this article with you from Inoreader Early surgical intervention enhances recovery of severe pediatric deep neck infection patients Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Int J Pediatr Otorhinolaryngol. 2021 Mar 28;144:110694. doi: 10.1016/j.ijporl.2021.110694. Online ahead of print. ABSTRACT PURPOSE: Pediatric deep neck space infection (DNI) is a relatively rare but potentially life-threatening condition and requires prompt and accurate management. This study retrospectively reviews our experience in a tertiary referral hospital from 2004 to 2019. METHODS: Systematic data collection from medical records using ICD10 codes between 2004 and 2019. INCLUSION CRITERIA: age ≤16 years, DNI requiring hospitalization and/or surgery. EXCLUSION: peritonsillar abscess without complications. RESULTS: We identified 42 patients, 21 boys and 21 girls, with a median age of 4.9 years. Most of the patients had severe symptoms, the most common of which were neck swelling (n = 39; 92.9%), neck pain (n = 39; 92.9%) and fever (n = 32; 76.2%). Twenty-two (52.4%) had torticollis, and the mean duration of sym ptoms before hospitalization was 4.95 days. Diagnosis was confirmed by MRI (n = 24), contrast-enhanced CT (n = 11) or ultrasonography (n = 6), except in one case. Twenty-three (54.8%) required an open neck incision, ten (23.8%) patients had intraoral surgery and nine were treated conservatively. Twelve (28.6%) patients were admitted to the pediatric ICU. Median hospitalization duration was six days. The infection most commonly had tonsillopharyngeal etiology (n = 18) and a retropharyngeal location (n = 17). Staphylococcus Aureus (n = 7) and Streptococcus pyogenes (n = 7) were the most frequent pathogens. We compared the early surgical intervention group (<2 days of intravenous antibiotics; n = 18; 42.9%) to the late surgery group (n = 15; 35.7%) and the conservatively treated groups (n = 9; 21.4%). The overall length of stay (LOS) was lower in the shorter preoperative medication group (mean 4.4 vs. 7.2; p = 0.009). The size of the abscess did not differ between the groups (mean 2 8 mm; 30 mm; 21 mm; p = 0.075) and the neck incision rate was similar in the operated groups. CONCLUSION: Early surgical intervention is associated with decreased LOS among severe pediatric DNI patients. PMID:33799100 | DOI:10.1016/j.ijporl.2021.110694 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.