Author(s): Coticchia JM, Getnick GS, Yun RD, Arnold JE
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Abstract OBJECTIVE: To clarify presentations, organisms, and locations of deep neck abscesses in children. DESIGN: Retrospective review. SETTING: Tertiary children's hospital. The study population comprised 169 patients younger than 19 years who were surgically treated for deep neck abscesses between 1989 and 1999. MAIN OUTCOME MEASURE: Resolution of abscess. RESULTS: Neck mass (91\%), fever (86\%), cervical adenopathy (83\%), poor oral intake (66\%), and neck stiffness (59\%) were common in all ages. Patients younger than 4 years, compared with patients 4 years or older, presented with agitation (50\% vs 14\%), cough (35\% vs 14\%), drooling (27\% vs 12\%), lethargy (46\% vs 33\%), oropharyngeal abnormalities (45\% vs 60\%), respiratory distress (5\% vs 2\%), retractions (5\% vs 2\%), rhinorrhea (53\% vs 15\%), stridor (4\% vs 2\%), and trismus (14\% vs 53\%). Children younger than 1 year were infected with Staphylococcus aureus (79\%) vs group A streptococcus (6\%). Children 1 year or older were infected with group A streptococcus (29\%) vs S aureus (16\%). Retropharyngeal or parapharyngeal regions were involved in children 1 year or older (49\%) vs younger than 1 year (21\%). Anterior or posterior triangles and submandibular or submental regions were involved in 39\% and 36\%, respectively, of children younger than 1 year vs 30\% and 23\%, respectively, of children 1 year or older. Retropharyngeal and parapharyngeal abscesses yielded group A streptococcus (34\%) vs S aureus (11\%). Anterior and posterior triangle abscesses yielded S aureus (35\%) vs group A streptococcus (19\%), as did submandibular and submental abscesses (42\% vs 19\%). CONCLUSIONS: Abscesses in children younger than 1 year affected anterior or posterior triangles and submandibular or submental regions, yielding S aureus. Abscesses in children 1 year or older affected retropharyngeal or parapharyngeal regions, yielding group A streptococcus.
This article was published in Arch Otolaryngol Head Neck Surg
and referenced in Emergency Medicine: Open Access