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Paediatric neck abscesses: microbiology and management

Published online by Cambridge University Press:  11 June 2007

I K Rustom ,
J A T Sandoe  and
Z G G Makura
I K Rustom*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Leeds General Infirmary, UK
J A T Sandoe
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Leeds General Infirmary, UK
Z G G Makura
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Leeds General Infirmary, UK
*
Address for Correspondence: Mr Isam Rustom, 8 Sycamore Close, Meanwood, Leeds LS7 2UN, UK. Fax: +44113 392 3165, E-mail: [email protected]
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Abstract

Introduction:

Paediatric neck abscesses remain common problems which are sometimes difficult to manage.

Methods and materials:

We conducted a retrospective study of 64 children who underwent incision and drainage of neck abscesses at Leeds General Infirmary from 1 February 2002 to 31 July 2006. The aim of this study was to identify the presenting symptoms in children, the appropriateness of prescribed antibiotics and the role of atypical mycobacteria in neck infections. The outcome measure was clinical resolution of the abscess.

Results:

The mean presenting age was 44.2 months (3.68 years). The commonest sign and symptom was neck mass (96.9 per cent). The mean period of hospitalisation was 3.7 (± standard deviation of 1.9) days. Staphylococcus aureus (48.4 per cent) was the commonest organism cultured. Atypical mycobacteria were found in only 4.7 per cent of the specimens. Flucloxacillin was the most common antibiotic used (57.8 per cent), often in combination with other antimicrobials. The abscess recurrence rate was 4.7 per cent. No fatalities occurred in this series of patients.

Conclusion:

Appropriately prescribed intravenous antibiotics and surgical drainage remain the central core of treatment. Atypical mycobacterial infection is an important differential diagnosis of a painless, cervico-facial mass. An algorithm for the management of paediatric neck abscesses is proposed.

Keywords

Head and NeckAbscessChildren
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 5 , May 2008 , pp. 480 - 484
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 Elden, LM, Grundfast, KM, Vezina, G. Accuracy and usefulness of radiographic assessment of cervical neck infections in children. J Laryngol Otol 2001;30:82–90Google ScholarPubMed
2 Simo, R, Hartley, C, Rapado, F, Zarod, AP, Sanyal, D, Rothera, MP. Microbiology and antibiotics treatment of head and neck abscesses in children. Clin Otolaryngol 1998;23:164–8CrossRefGoogle ScholarPubMed
3 Coticchia, JM, Getnick, GS, Yun, RD, Arnold, JE. Age-, site-, and time-specific differences in pediatric deep neck abscesses. Arch Otolaryngol Head Neck Surg 2004;130:201–7CrossRefGoogle ScholarPubMed
4 Choi, SS, Vezina, LG, Grundfast, KM. Relative incidence and alternative approaches for surgical drainage of different types of deep neck abscesses in children. Arch Otolaryngol Head Neck Surg 1997;123:1271–5CrossRefGoogle ScholarPubMed
5 Nagy, M, Pizzuto, M, Backstrom, I, Brodsky, L. Deep neck infections in children: a new approach to diagnosis and treatment. Laryngoscope 1997;107:1627–34CrossRefGoogle ScholarPubMed
6 Parhiscar, A, Har-El, G. Deep neck abscess: a retrospective review of 210 cases. Ann Otol Rhinol Laryngol 2001;110:1051–5CrossRefGoogle ScholarPubMed
7 Cmejrek, RC, Coticchia, JM, Arnold, JE. Presentation, diagnosis, and management of deep-neck abscesses in infants. Arch Otolaryngol Head Neck Surg 2002;128:1361–4CrossRefGoogle ScholarPubMed
8 Dodds, B, Maniglia, AJ. Peritonsillar and neck abscesses in the pediatric age group. Laryngoscope 1988;98:956–9CrossRefGoogle ScholarPubMed
9 Ungkanont, K, Yellon, RF, Weissman, JL, Casselbrant, ML, Gonzalez-Valdepena, H, Bluestone, CD. Head and neck space infections in infants and children. Otolaryngol Head Neck Surg 1995;112:375–82CrossRefGoogle ScholarPubMed
10 Benson-Mitchell, R, Buchanan, G. Cervical lymphadenopathy secondary to atypical mycobacteria in children. J Laryngol Otol 1996;110:48–51CrossRefGoogle ScholarPubMed
11 Cox, HJ, Brightwell, AP, Riordan, T. Non-tuberculous mycobacterial infections presenting as salivary gland masses in children: investigation and conservative management. J Laryngol Otol 1995;109:525–30CrossRefGoogle ScholarPubMed
12 Tom, MB, Rice, DH. Presentation and management of neck abscess: a retrospective analysis. Laryngoscope 1988;98:877–80CrossRefGoogle ScholarPubMed
13 Beck, AL. The influence of the chemotherapeutic and antibiotic drugs on the incidence and course of deep neck infections. Ann Otol Rhinol Laryngol 1952;61:515–32CrossRefGoogle ScholarPubMed
14 Gidley, PW, Ghorayeb, BY, Stiernberg, CM. Contemporary management of deep neck space infections. Otolaryngol Head Neck Surg 1997;116:16–22Google ScholarPubMed
15 Brook, I. Microbiology of abscesses of the head and neck in children. Ann Otol Rhinol Laryngol 1987;96:429–33CrossRefGoogle ScholarPubMed
16 Tami, TA, Parker, GS. Eikenella corrodens: an emerging pathogen in head and neck infections. Arch Otolaryngol 1984;110:752–4CrossRefGoogle ScholarPubMed
17 Quraishi, MS, O'Halpin, DR, Blayney, AW. Ultrasonography in the evaluation of neck abscesses in children. Clin Otolaryngol 1996;22:30–3CrossRefGoogle Scholar