TY - JOUR
T1 - Head and neck space infections in infants and children
AU - UNGKANONT, KITIRAT
AU - YELLON, ROBERT F.
AU - WEISSMAN, JANE L.
AU - CASSELBRANT, MARGARETHA L.
AU - GONZÁLEZ-VALDEPEÑA, HUGO
AU - BLUESTONE, CHARLES D.
PY - 1995/3
Y1 - 1995/3
N2 - A retrospective study was performed in 117 children with head and neck space infections treated at the Children's Hospital of Pittsburgh from January 1986 through June 1992. Peritonsillar space infections were the most common (49%), followed by retropharyngeal (22%), submandibular (14%), buccal (11%), parapharyngeal (2%), and canine (2%) space infections. The most common pathogens isolated (N = 78) were the aerobes β-hemolytic streptococcus (18%) and Staphylococcus aureus (18%), the anaerobes Bacteroides melaninogenicus (17%) and Veillonella (14%), and the gram-negative organism Haemophilus parainfluenzae (14%). β-Lactamase production by aerobic pathogens was detected in 22% of cultures. Computed tomography scans (N = 16) were reviewed in blinded fashion and compared with operative findings. The sensitivity of computed tomography scan in detecting the presence of an abscess vs. cellulitis was high (91%), whereas the specificity was rather low (60%). Treatment of head and neck space infections in children should consist of accurate physical diagnosis aided by imaging studies, empiric antibiotic therapy that covers gram-negative and β-lactamase-producing organisms as well as gram-positive organisms and anaerobes, and timely surgical intervention, when indicated. (OTOLARYNGOL HEAD NECK SURG 1995;112:375-82.).
AB - A retrospective study was performed in 117 children with head and neck space infections treated at the Children's Hospital of Pittsburgh from January 1986 through June 1992. Peritonsillar space infections were the most common (49%), followed by retropharyngeal (22%), submandibular (14%), buccal (11%), parapharyngeal (2%), and canine (2%) space infections. The most common pathogens isolated (N = 78) were the aerobes β-hemolytic streptococcus (18%) and Staphylococcus aureus (18%), the anaerobes Bacteroides melaninogenicus (17%) and Veillonella (14%), and the gram-negative organism Haemophilus parainfluenzae (14%). β-Lactamase production by aerobic pathogens was detected in 22% of cultures. Computed tomography scans (N = 16) were reviewed in blinded fashion and compared with operative findings. The sensitivity of computed tomography scan in detecting the presence of an abscess vs. cellulitis was high (91%), whereas the specificity was rather low (60%). Treatment of head and neck space infections in children should consist of accurate physical diagnosis aided by imaging studies, empiric antibiotic therapy that covers gram-negative and β-lactamase-producing organisms as well as gram-positive organisms and anaerobes, and timely surgical intervention, when indicated. (OTOLARYNGOL HEAD NECK SURG 1995;112:375-82.).
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U2 - 10.1016/S0194-5998(95)70270-9
DO - 10.1016/S0194-5998(95)70270-9
M3 - Article
C2 - 7870436
AN - SCOPUS:0028901096
SN - 0194-5998
VL - 112
SP - 375
EP - 382
JO - Otolaryngology - Head and Neck Surgery
JF - Otolaryngology - Head and Neck Surgery
IS - 3
ER -