Deep Neck Abscesses in Children: An Italian Retrospective Study.

Autor:	Donà D; From the Division of Pediatric Infectious Diseases., Gastaldi A; Department for Woman and Child Health-Pediatric Emergency Department, University of Padua, Padua., Campagna M; Department for Woman and Child Health-Pediatric Emergency Department, University of Padua, Padua., Montagnani C; Pediatric Infectious Diseases Unit, Anna Meyer Children's University Hospital, Florence., Galli L, Trapani S; Pediatric Infectious Diseases Unit, Anna Meyer Children's University Hospital, Florence., Pierossi N; Pediatric Infectious Diseases Unit, Anna Meyer Children's University Hospital, Florence., De Luca M; Unit of Immune and Infectious Diseases, University Department of Pediatrics, Bambino Gesù Children's Hospital., D'Argenio P; Unit of Immune and Infectious Diseases, University Department of Pediatrics, Bambino Gesù Children's Hospital., Tucci FM; Unit of Otolaryngology-Head and Neck Surgery, Bambino Gesù Children's Hospital Research Institute, Rome., De Vincentiis G; Unit of Otolaryngology-Head and Neck Surgery, Bambino Gesù Children's Hospital Research Institute, Rome., Grotto P; Division of Pediatrics, S. Maria of Ca' Foncello., Da Mosto MC; Department of Neurosciences, University of Padua, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, Treviso., Frigo AC; Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences., Volo T; Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University of Padua, Padua, Italy., Emanuelli E; Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University of Padua, Padua, Italy., Martini A; Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University of Padua, Padua, Italy., Da Dalt L; Department for Woman and Child Health-Pediatric Emergency Department, University of Padua, Padua.
Jazyk:	angličtina
Zdroj:	Pediatric emergency care [Pediatr Emerg Care] 2021 Dec 01; Vol. 37 (12), pp. e1358-e1365.
DOI:	10.1097/PEC.0000000000002037
Abstrakt:	Background: Retropharyngeal and parapharyngeal abscesses (RPAs, PPAs) usually affect young children. Surgical drainage and/or antibiotic therapy are treatment of choice, but no specific guidelines exist. In order to reduce the risk of severe complications, appropriate diagnosis and therapy are necessary. The aims of the study were to review diagnosis and management of children with RPAs/PPAs and to compare surgical versus medical approach. Methods: This is a multicenter retrospective study including all patients younger than 15 years admitted at 4 Italian pediatric hospitals of Florence, Padua, Rome, and Treviso, with International Classification of Diseases, Ninth Revision discharge diagnosis code of RPAs and PPAs, from January 1, 2008, to December 31, 2016. Results: One hundred fifty-three children were included. The median age was 4.4 years, with overall male predominance. Heterogeneous signs and symptoms (fever, neck cervical, lymphadenopathy, pain, and stiff neck most frequently) and a large mixture of bacteria from pus cultures were detected. Computer tomography (66.7%) and magnetic resonance imaging (27.5%) were performed to confirm the presence of abscess. Fifty-one percent of abscesses were greater than 3 cm. Eighty-seven patients (56.9%) underwent surgery, and 66 (43.1%) were treated with antibiotics alone (mostly ceftriaxone, metronidazole, amikacin, and clindamycin) with median days of therapy of 26.5 days and length of therapy of 16.0 days of median. Median length of stay was 11 days. None had severe complications. Multivariate analysis indicated as independent predictive factors of surgery abscess of 3 cm or greater, high white blood cell count, and-most of all-the hospital of admission. Conclusions: Deep neck abscesses mostly affect patients in early childhood, with a combination of nonspecific signs and symptoms, and it still emerges as a heterogeneous approach in diagnosis and management of these infections. Thus, common shared protocols represent an essential tool in order to standardize care and improve patients' outcomes. Competing Interests: Disclosure: The authors declare no conflict of interest. (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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