Characteristic of Deep Neck Infection in Buriram Hospital

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Korrapat Aegakkatajit


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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