Print E-mail
Volume 43, Number 1, February 2010

Deep Neck Infections in Different Age Groups of Children


Lung Chang, Hsin Chia, Nan-Chang Chiua, Fu-Yuan Huang, Kou-Sheng Lee


Received: December 31, 2008    Revised: February 10, 2009    Accepted: February 23, 2009   

 

Corresponding author:

Department of Pediatrics,Mackay Memorial Hospital, 92 Section 2, Chung Shan North Road, Taipei 10449, Taiwan.
E-mail: ncc88@ms2.mmh.org.tw



 

Background and purpose: 

Deep neck infections (DNIs) can cause significant morbidity in children. This study analyzes the clinical presentations, diagnostic clues, and age relationship of DNI in pediatric patients.



 

Methods:

Pediatric patients admitted to our hospital from January 1996 to December 2007 with a diagnosis of DNIs were reviewed retrospectively. Diseases were categorized according to the site of infection: peritonsillar, parapharyngeal, and retropharyngeal spaces. Patients were divided into two groups: children (aged < 10 years) and adolescents (aged 10–18 years).



 

Results:

Fifty pediatric patients were enrolled, including nine with DNI in the retropharyngeal space, 17 in the parapharyngeal, 21 in the peritonsillar and three with mixed type abscesses. A total of 21 patients belonged to the child group, and 29 were adolescents. All retropharyngeal abscesses occurred in children; whereas most peritonsillar abscesses (81%) were found in adolescents. Most retropharyngeal and parapharyngeal abscesses were associated with fever (100% and 65%, respectively) and neck masses (67% and 94%, respectively); while odynophagia was the most common symptom in peritonsillar abscess (100%). Thirtytwo abscess cultures were obtained and seven grew mixed pathogens, followed by Streptococcus pyogenes (n = 5), and normal flora (n = 5). Complications of airway obstruction arose in one patient with parapharyngeal abscess, and mediastinitis in another two patients with retropharyngeal abscesses. Recurrent DNIs were observed in six patients; three had congenital bronchogenic cysts.



 

Conclusion:

The location of the DNI appears to vary in different pediatric age groups. Its insidious presentation, with a potentially complicated course, warrants careful inspection in children with fever and neck masses, especially young children.



 

Key words:

children, parapharyngeal abscess, peritonsillar abscess, retropharyngeal abscess