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A clinical study of deep neck abscess in children

Korean Journal of Pediatrics 2007;50(4):363-368.
Published online April 15, 2007.
A clinical study of deep neck abscess in children
Soo Jung Lee1, Mee Yong Shin1, Chang Hwi Kim1, Yoon Woo Koh2
1Department of Pediatrics, School of Medicine, Soonchunhyang University, Bucheon, Korea
2Department of Otolaryngology, School of Medicine, Soonchunhyang University, Bucheon, Korea
소아 심경부 농양의 임상적 고찰
이수정1, 신미용1, 김창휘1, 고윤우2
1순천향대학교 의과대학 소아과학교실
2순천향대학교 의과대학 이비인후과학교실
Correspondence: 
Mee Yong Shin, Email: smy0218@schbc.ac.kr
Abstract
Purpose
: It has been reported that deep neck abscesses are recently increasing again. We analyzed pediatric cases with deep neck abscesses during the last several years to contribute to the treatment of the disease.
Methods
: The clinical data of 30 children under 16 years of age with deep neck abscess from February 2001 to July 2006 were analysed retrospectively.
Results
: The mean age was 9 years (2-16 years), and the male/female ratio was 19/11. Abscesses in the peritonsillar space were most common (57%), followed by the retropharyngeal (30%) and parapharyngeal (13%) spaces. Upper respiratory infection in 10 cases (33%), dental infection in four case (14%), cervical lymphadenitis in three case (10%) and sinusitis in two case (6%) contributed to the development of deep neck infections. The frequent symptoms were fever in 16 case (53%), sore throat in 15 case (50%), poor oral intake in 10 (33%), odynophagia in eight (27%), and neck pain in eight (27%). Unilateral tonsillar hypertrophy and displacement in 15 case (50%) were most common. Neck mass in 13 patients (43%), neck stiffness in three (10%) and trismus in three (10%) were also found. Bacteria were isolated in 8 among 10 pus cultures; Streptococcus species 7 and Micrococcus luteus 1. All of those bacteria except Micrococcus luteus were sensitive to penicillin G. Surgical intervention was applied to 12 cases (40%), and the remaining 18 patients (60%) were treated with antibiotics only. There were no differences between the two groups in the duration of admission and antibiotic treatment. No complicated cases were observed.
Conclusion
: Peritonsillar abscesses were most frequent. Upper respiratory infection was the most common predisposing factor, followed by dental infection and sinusitis. Symptoms of respiratory tract obstruction were not found. The most common pathogens were Streptococcus species. Deep neck abscesses in children, if diagnosed at the early stage, possibly can be treated by antibiotics only, without surgical intervention.
Key Words: Abscess , Neck , Child , Streptococcus


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