TY - JOUR
T1 - Diagnosis and management of deep neck infections in children
T2 - The experience of an Italian paediatric centre
AU - Raffaldi, Irene
AU - Le Serre, Daniele
AU - Garazzino, Silvia
AU - Scolfaro, Carlo
AU - Bertaina, Chiara
AU - Mignone, Federica
AU - Peradotto, Federica
AU - Tavormina, Paolo
AU - Tovo, Pier Angelo
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Deep neck infection (DNI) is a severe occurrence in children. We've examined the presenting signs and symptoms, the value of single diagnostic procedures, the rate of complications and the impact of the therapeutic options on the final outcome, in children with a DNI.We retrospectively evaluated patients, aged 0-18 years, who were admitted for a DNI, from January 2006 through December 2012, at Regina Margherita Children's Hospital, Turin, Italy. We subdivided them on the basis of type of treatment: pharmacological treatment alone or antimicrobial treatment plus surgery. An univariate analysis has been performed to examine the differences between the two groups.Sixty patients (32 males, 28 females) with diagnosis of DNI were enrolled; 33 children only received medical treatment (group 1), whereas 27 patients underwent also surgical interventions (group 2). The mean abscess size was significantly higher in group 2 than in group 1 (. p=0.01). The predominant organisms were Streptococcus sp. (11 cases, 52.4%, mostly Streptococcus pyogenes). The most frequent antibiotic regimen was a β lactam alone (either III generation cephalosporin or amoxicillin/clavulanate). The duration of intravenous antibiotic varied between the two groups, without statistical significance (. p=0.052); whereas the oral antibiotic administration was significantly shorter in group 1 than in group 2 (. p=0.0003). Three patients (5%) developed complications.This research confirms that the medical approach, with high doses of intravenous antibiotics for a minimum of 5 days, could be a tolerable and safe option for the treatment of patients with stable condition and/or small DNIs.
AB - Deep neck infection (DNI) is a severe occurrence in children. We've examined the presenting signs and symptoms, the value of single diagnostic procedures, the rate of complications and the impact of the therapeutic options on the final outcome, in children with a DNI.We retrospectively evaluated patients, aged 0-18 years, who were admitted for a DNI, from January 2006 through December 2012, at Regina Margherita Children's Hospital, Turin, Italy. We subdivided them on the basis of type of treatment: pharmacological treatment alone or antimicrobial treatment plus surgery. An univariate analysis has been performed to examine the differences between the two groups.Sixty patients (32 males, 28 females) with diagnosis of DNI were enrolled; 33 children only received medical treatment (group 1), whereas 27 patients underwent also surgical interventions (group 2). The mean abscess size was significantly higher in group 2 than in group 1 (. p=0.01). The predominant organisms were Streptococcus sp. (11 cases, 52.4%, mostly Streptococcus pyogenes). The most frequent antibiotic regimen was a β lactam alone (either III generation cephalosporin or amoxicillin/clavulanate). The duration of intravenous antibiotic varied between the two groups, without statistical significance (. p=0.052); whereas the oral antibiotic administration was significantly shorter in group 1 than in group 2 (. p=0.0003). Three patients (5%) developed complications.This research confirms that the medical approach, with high doses of intravenous antibiotics for a minimum of 5 days, could be a tolerable and safe option for the treatment of patients with stable condition and/or small DNIs.
KW - Antibiotic treatment
KW - Children
KW - Complications
KW - Deep neck infections
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=84928330297&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928330297&partnerID=8YFLogxK
U2 - 10.1016/j.jiac.2014.10.011
DO - 10.1016/j.jiac.2014.10.011
M3 - Article
C2 - 25456894
AN - SCOPUS:84928330297
VL - 21
SP - 110
EP - 113
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
SN - 1341-321X
IS - 2
ER -