Presentation diagnosis and management of deep neck space infections in children

ABSTRACT

the objective of this study is to review the pattern, the presenting symptoms and signs, bacteriology and management of deep neck spaces infection [DNSI] in children. Method: This is a retrospective review of the charts of all children seen in Ear Nose and Throat [ENT] department of Assir central Hospital of King Khalid University Abha. Saudi Arabia. The patients database was searched by using the diagnosis Peritonsillar Space Infection [PTSI], Parapharyngeal Space Infection [RTSI]. The search included inpatients and those on outpatients' visits of patients below the age of 12 years from 1999-2002. The charts were reviewed and data regarding presentation, management and outcome were recorded. Some comparisons with current trend in the literature were made, Twenty- four patients were identified, 16 with PTSI, 6 with PPSI and 2 with RTSI. The most common symptoms in the 3 groups were fever and dysphagia. Intravenous antimicrobial therapy was the main stay of treatment in 16 [66.6%] of the 24 patients. In patients with already formed abscess antimicrobial therapy with surgical drainage was the preferred treatment. Positive culture was obtained in 75% of patients with the predominance of streptococcus species. Descending mediastinitis complicated one case. All the patients survived without residual sequalae. Deep neck space infections in children are rapidly progressive and often cause obstruction. Patients are effectively treated with surgical drainage coupled with intravenous followed by oral antibiotics