Characteristic of Deep Neck Infection in Buriram Hospital

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Korrapat Aegakkatajit

Abstract

Background: Deep neck infection is an infection in the potential spaces and fascial planes. Despite widespread use of antibiotics, the incidence of deep neck infection was still high and canleads to fatal complications.
Objective: To review characteristic, clinical course, bacteriology and treatment of deep neck infection in Buri Ram Hospital, compare to the experiences of the common literature and identify predisposing factors for complications.
Methods: The records of patients treated for deep neck infection in Inpatient department of Buri Ram Hospital during the period from 2016 -2018 were retrospectively reviewed.
Results: Among 350 deep neck infection patients, there was predominant of male patient (58.3%). It can occur in any age groups but most common in six decade of life (17.1%). Mean duration of hospital stay was 5.6 days. The patients usually presented with swelling of face or neck (72%) and fever (32.9%). Dental infection was the most common cause (49.7%). The most common comorbidities were hypertension (16.6%) and diabetes mellitus (12.6%). Submandibular space was the most frequent space of infection (32.3%). The most commonly aerobe organisms isolated from pus were Klebsiella pneumoniae and Staphylococcus epidermidis. Surgical drainage was performed in 68.6% of cases and in 14% of cases can successfully treated with aspiration. Among all complications, upper airway obstruction was the most common (14%). There were 2 patients died from deep neck infection (0.6%). Elderly patients aged above 65 and patients with multiple spaces infection were significantly associated with complications. Patients who have complication, diabetes mellitus, anemia or multiple spaces infection were significantly associated with prolonged duration of hospital stay.
Conclusion: Deep neck infection was still problem for otolarygologist which dental problem was main cause of infection. Elderly patients and patients with multiple spaces infection should be treated with close observation due to higher risk for complication. Surgical drainage was still mainstay for treatment but in some cases, aspiration can be used as optional treatment.
Keywords: deep neck infection, complication.

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References

1. Kinzer S, Pfeiffer J, Becker S, Ridder GJ. Severe deep neck space infections and mediastinitis of odontogenic origin: clinical relevance and implications for diagnosis and treatment. Acta Otolaryngol 2009;129:62-70

2. Poeschl PW, Spusta L, Russmueller G, Seemann R, Hirschl A, Poeschl E, et al. Antibiotic susceptibility and resistance of the odontogenic microbiological spectrum and its clinical impact on severe deep space head and neck infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110:151-6

3. Kongtangchit P. Deep neck infection : Comparison of clinical course and outcome between diabetic and non-diabetic patients. Thai J Otolaryngol Head Neck Surg 2013;14:35-51.

4. Surapol S, Wisoot R, Seksun C, Patorn P, Deep Neck Infection in Adults: Factors Associated with Complicated Treatment Outcomes J Med Assoc Thai 2017;100:179-188

5. Philipp K, Robert C , Markus T, Christian S ,Rainer L, Deep neck infections: A single-center analysis of 63 cases, Med Oral Patol Oral Cir Bucal. 2017;22(5):536-41

6. Parhiscar, A., and G. Har-El. “Deep Neck Abscess: A Retrospective Review of 210 Cases.” The Annals of Otology, Rhinology, and Laryngology . 2001,110(11):1051–54.

7. บุญชัย วิรบุญชัย. Deep Neck Infection in Surin Hospital. วารสารทางการแพทย์โรงพยาบาลศรีสะเกษ สุรินทร์ บุรีรัมย์ 2544;24(7):173-180

8. วุฒิเวช จรัสมานะโชติ. Retrospective Study of Deep Head and Neck Infection in Chaoprayayomraj Hospital. วารสารแพทย์เขต 4-5 2556;32(3):201-12

9. Boscolo-Rizzo P, Marchiori C, Montolli F, Vaglia A, Da Mosto MC. Deep neck infections: a constant challenge. ORL J Otorhinolaryngol Relat Spec 2006;68:259-65.

10. Daramola OO, Flanagan CE, Maisel RH, Odland RM. Diagnosis and treatment of deep neck space abscesses. Otolaryngol Head Neck Surg. 2009;141:123-30.

11. ชวน ชีพเจริญรัตน์. ลักษณะการติดเชื้อลำคอส่วนลึกและการเสียชีวิตในโรงพยาบาลประชานุเคราะห์. Thai J Otolaryngol Head Neck Surg, 2017,18(1):44-55

12.พิมวิชญา ซื่อทรงธรรม, สุพจน์ เจริญสมบัติอมร, จิระพงษ์ อังคะรา. การอักเสบติดเชื้อของลำคอชั้นลึกในคณะแพทยศาสตร์วชิรพยาบาลมหาวิทยาลัยนวมินทราธิราช. Vajira Med J. 2018;62(5):365-74

13. Wongnijasil, C. “Deep Neck Abscess Clinical Review at Khon Kaen Hospital.” Khon Kaen Hospital Medical Journal ,2008;(32):147–54.

14. Nikakhlagh S, Rahim F, Saki G, et al. Deep Neck Infections : a case study of 12-year. Asian J Biol Sci. 2010;3(3):128-33.

15. Paolo BR, Marco S, Enrico M, Monica M, Roberto F, Valentina L, Franco T, Maria C, Deep neck infections: a study of 365 cases highlightingrecommendations for management and treatment. Eur Arch Otorhinolaryngol. 2012,269:1241–1249

16. Kanthong, Sathit. Retrospective Study of Incidence and Treatment Outcome of Deep Neck Infection and Facial Space Abscess for 491 Patients at Chaiyaphum Hospital During 1999 to 2007. Khon Kaen Hospital Medical Journal 2018;32:153-64