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Çocukluklarda Derin Boyun Enfeksiyonlarının Değerlendirilmesi: 5 Yıllık Retrospektif Çalışma

Yıl 2023, Cilt: 2 Sayı: 2, 92 - 97, 19.06.2023

Berfin Özgökçe Özmen Mehtap Akça Edanur Yeşil Merve Türkegün Şengül Necdet Kuyucu

https://doi.org/10.57221/izmirtip.1285651

Öz

Amaç: Bu çalışmada, Çocuk Enfeksiyon Hastalıkları servisimizde derin boyun enfeksiyonu (DBE) tanısıyla yatarak takip edilen olguların demografik özellikleri, klinik, mikrobiyolojik ve radyolojik bulguları ile beraber enfeksiyon yeri ve yaş gruplarına ayrılarak değerlendirildi. Gereç ve Yöntem: Ocak 2017-Aralık 2022 tarihleri arasında olguların demografik özellikleri, klinik, mikrobiyolojik ve radyolojik ile beraber bulaşma yeri ve yaş gruplarına ayrılarak değerlendirildi. Bulgular: Toplam 39 DBE tanısı olan olgu izlendi. Olguların 22’si (%56,4) 10 yaş altında, 17’si (%43,6) 10-18 yaş arasındaydı. En sık semptom/belirtiler; yüksek ateş (%97,4) ve boyunda şişlik (%94,9) idi. On iki olguda (%30,8) peritonsiller, dokuz olguda (%23,1) retrofaringeal, on dört olguda (%35,9) parafaringeal, diğer dört olguda (%10,3) dil kökü enfeksiyonu saptandı. Başvuru sırasında tüm hastalara intravenöz (iv) antibiyotik verildi ve %66,7'sine apse drenajı yapıldı. Olgulara sıklıkla (%41) ampisilin-sulbaktam ya da (%25,6) ampisilin-sulbaktam + klindamisin verildi. On üç olgu (%33,3) sadece antibiyotik tedavisi ile düzeldi. Diğer yirmi altı olguya (%66,7) cerrahi drenaj uygulandı ve apse kültürü alındı. Hastaların on dördünde (%35,8) drenaj materyalinde mikroorganizma üredi ve en sık izole edilen patojen Metisilin duyarlı Staphylococcus aureus (MSSA) idi. Cinsiyet ile yaş grupları arasında istatistiksel olarak anlamlı bir ilişki görülmedi (p=0.358). Enfeksiyon alanı ile yaş grupları arasında istatistiksel olarak anlamlı bir ilişki izlenmedi (p=0.06). Hastanede yatış süresi medyanları ile enfeksiyon alanları arasında istatistiksel olarak anlamlı bir farklılık saptanmadı (p=0.087). Sonuç: Yüksek ateş ve boyunda şişlik şikayeti ile başvuran çocuklarda ayırıcı tanıda DBE düşünülmelidir. Çalışmamızda yaş grupları ile enfeksiyon alanları arasında, olguların çoğu antibiyotik ile düzelmektedir, ancak tedaviye yanıt alınmayan olgularda gecikmeden cerrahi drenaj uygulanmalıdır.

Anahtar Kelimeler

Çocuk derin boyun enfeksiyonları parafaringeal apse peritonsiller apse retrofaringeal apse

Kaynakça

  • Referans1.Goldstein NA, Hammerschlag MR. Peritonsillar, retropharyngeal, and parapharyngeal abscess. In: Feigin RD, Demmler GJ, Cherry JD, et al., editors. Textbook of Pediatric Infectious Disease. 2004. 5th ed ed. Philadelphia: WB Saunders. p. 178-85.
  • Referans2.Chang L, Chi H, Chiu NC, Huang FY, Lee KS. Deep neck infections in different age groups of children. J Microbiol Immunol Infect. 2010;43: 47-52.
  • Referans3.Weed HG, Forrest LA. Deep neck infection. Otolaryngology Head and Neck Surgery'de Ed.Charles W. Cummings Third Edition, Volume Three, St. Lois, Missouri, 1998;1700-1.
  • Referans4.Goldstein NA, Hammerschlag MR. Peritonsillar, retropharyngeal, and parapharyngeal abscesses. In: Feigin RD, Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez BJ, editors. Textbook of Pediatric Infectious Disease, 8th ed. Philadelphia, PA: Elsevier, 2019. p: 117-23.
  • Referans5. Parhiscar A, Har-El G. Deep neck abscess: A retrospective review of 210 cases. Ann Otol Rhinol Laryngol 2001;110:1051-4.
  • Referans6. Baldassari CM, Howell R, Amorn M, Budacki R, Choi S, Pena M. Complications in pediatric deep neck space abscesses. Otolaryngol Head Neck Surg. 2011;144:592-5.
  • Referans7.Huang TT, Liu TC, Chen PR, Tseng FY, Yeh TH, Chen YS. Deep neck infection: analysis of 185 cases. Head Neck. 2004;26: 854-60.
  • Referans8.Chang L, Chi H, Chiu NC, Huang FY, Lee KS. Deep neck infections in different age groups of children. J Microbiol Immunol Infect. 2010;43:47-52.
  • Referans9.Da Silva PS, Waisberg DR. Internal carotid artery pseudoaneurysm with life-threatening epistaxis as a complication of deep neck space infection. Pediatr Emerg Care. 2011; 27: 422-4.
  • Referans10.Schwartz RH. Infections related to the upper and middle airways. In: Long SS, Pickering LK, Prober CG editors. Pediatric Infectious Diseases. 3rd ed. Churchill Livingstone Elsevier; 2008; p: 213-7.
  • Referans11. Brook I. Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses. J Oral Maxillofac Surg. 2004;62:1545-50.
  • Referans12. Tan PT, Chang LY, Huang YC, Chiu CH, Wang CR, Lin TY. Deep neck infections in children. J Microbiol Immunol Infect. 2001;34:287-92.
  • Referans13. Yang YS, Lee HU, Lee SH, Hong KH. A clinical study of the deep neck infections in children. Korean J Otolaryngol – Head Neck Surg. 2004;47:1282-8. Referans14. Bottin R, Marioni G, Rinaldi R, Boninsegna M, Salvadori L, Staffieri A. Deep neck infection: a present-day complication. A retrospective review of 83 cases (1998-2001). Eur Arch Otorhinolaryngol. 2003;260:576-9.
  • Referans15. Ünsal Tuna EE, Özel E, Özbek C, Özdem C. Derin boyun enfeksiyonu: 63 hastanın incelenmesi. Turk Arch Otolaryngol. 2008;46:73-7. Referans16. Coticchia JM, Getnick GS, Yun RD, Arnold JE. Age-, site-, and time-specific differences in pediatric deep neck abscesses. Arch Otolaryngol Head Neck Surg. 2004;130:201-7.
  • Referans17. Larawin V, Naipao J, Dubey SP. Head and neck space infections. Otolaryngol Head Neck Surg. 2006;135:889-3.
  • Referans18. Kaya EE, Taşar MA, Bilge YD. Evalutıon of deep neck infectionsin pediatric patients. Türkiye Çocuk Hast Derg. 2012;6:197-205.
  • Referans19. Cmejrek RC, Coticchia JM, Arnold JE. Presentation, diagnosis, and management of deep-neck abscesses in infants. Arch Otolaryngol Head Neck Surg. 2002;128:1361-4.
  • Referans20. Belet N, Tapısız A, Uçar Y. Deep neck infections in children. J Pediatr Inf. 2007;1:58-62.
  • Referans21. Metin Ö, Öz FN, Tanır G. Deep neck infections in children: experience in a tertiary care center in Turkey. The Turkish Journal of Pediatrics. 2014;56:272-9.
  • Referans22. Miller WD, Furst IM, Sandor GK, Keller MA. A prospective, blinded comparison of clinical examination and computed tomography in deep neck infections. Laryngoscope 1999;109:1873-9.
  • Referans23. Smith JL, Hsu JM, Chang J. Predicting deep neck space abscess using computed tomography. Am JOtolaryngol. 2006;27:244-7.
  • Referans24. Mayor GP, Millan JMS, Martinez VA. Is conservative treatment of deep neck space infections appropriate? J Head Neck. 2001;23:126-33.
  • Referans25.Goldstein NA, Hammerschlag MR. Peritonsillar,petropharyngeal, and parapharyngeal abscesses. In:Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJeditors. Feigin and Cherry’s Texbook of Pediatric Infectious Diseases. 7th ed. Philadelphia: Elseiver; 2014. p. 167-75.
  • Referans26. Sakaguchi M, Sato S, Ishiyama T, Katsuno S, Taguchi K. Characterization and management of deep neck infections. Int J Oral Max Surg. 1997;26:131-4.
  • Referans27.Wang LF, Kuo WR, Tsai SM, Huang KJ. Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otolaryngol. 2003;24:111-7.
  • Referans28. Eftekharian A, Roozbahany NA, Vaezeafshar R, Narimani N. Deep neck infections: a retrospective review of 112 cases. Eur Arch Otorhinolaryngol. 2009;266:273-7.
  • Referans29. Har-El G, Aroesty JH, Shaha A, Lucente FE. Changing trends in deep neck abscess: a retrospective study of 110 patients. Oral Surg Med. 1994;77:446-50. Referans30. Suehara AB, Gonçalves AJ, Alcadipani FAMC. Deep neck infection: analysis of 80 cases. Rev Bras Otorrinolaringol. 2008;74:253-9.
  • Referans31. Lee JK, Kim HD, Lim SC. Predisposing factors of complicated. Deep neck infection: an analysis of 158 cases. Yonsei Med J 2007;48:55-62.
  • Referans32. Ridder GJ, Technau-Ihling K, Sander A, Boedeker CC. Spectrum and management of deep neck space infections: an 8-year experience of 234 cases. Otolaryngol Head Neck Surg. 2005;133:709-14.

Evalution of Deep Neck Infections in Childhood: A-5 Year Retrospective Study

Yıl 2023, Cilt: 2 Sayı: 2, 92 - 97, 19.06.2023

Berfin Özgökçe Özmen Mehtap Akça Edanur Yeşil Merve Türkegün Şengül Necdet Kuyucu

https://doi.org/10.57221/izmirtip.1285651

Öz

Aim: In this study, the demographic characteristics of the patients who were hospitalized with the diagnosis of deep neck infections (DNI) in our Pediatric Infectious Diseases ward were evaluated by dividing the clinical, microbiological, and radiological findings into the site of infection and age groups. Materials and Methods: Between January 2017 and December 2022 the records of inpatients with DNI were reviewed retrospectively. Demographic characteristics of the cases, clinical, microbiological, and radiological findings, as well as the place of infection and age groups were evaluated. Results: A total of 39 patients with DNI were followed up. Twenty-two (56,4%) of the cases were under the age of 10 and 17 (43,6%) were between the ages of 10-18. The most common sign/symptoms were fever (97,4%) and neck swelling (94,9%). Peritonsillar infection was detected in 12 cases (30,8%), retropharyngeal infection in nine cases (23,1%), para pharyngeal infection in 14 cases (35,9%), and tongue root infection in four cases (10,3%). All patients were given intravenous (iv) antibiotics at the time of admission, and abscess drainage was performed in 66,7% of them. Ampicillin-sulbactam (41%) or ampicillin-sulbactam + clindamycin (25,6%) was given frequently (41%). Thirteen cases (33,3%) improved with antibiotic treatment alone. Surgical drainage was applied to the other twenty- six cases (66,7%) and an abscess culture was obtained. Microorganisms obtained in the drainage material in fourteen (35,8%) of the patients, and the most common pathogen was Methicillin. susceptible Staphylococcus aureus (MSSA). There was no statistically significant relationship between gender and age groups (p=0.358). There was no statistically significant relationship between the area of infection and age groups (p=0.06). The median length of stay in hospital and infection areas did not show a statistically significant difference (p=0.087 ). Conclusion: Deep neck infections should be considered in the differential diagnosis of children presenting with fever and neck swelling. In the study conducted between age groups and areas of infection, most of the cases improve with antibiotics, but surgical drainage should be applied without delay in cases that do not respond to treatment.

Kaynakça

  • Referans1.Goldstein NA, Hammerschlag MR. Peritonsillar, retropharyngeal, and parapharyngeal abscess. In: Feigin RD, Demmler GJ, Cherry JD, et al., editors. Textbook of Pediatric Infectious Disease. 2004. 5th ed ed. Philadelphia: WB Saunders. p. 178-85.
  • Referans2.Chang L, Chi H, Chiu NC, Huang FY, Lee KS. Deep neck infections in different age groups of children. J Microbiol Immunol Infect. 2010;43: 47-52.
  • Referans3.Weed HG, Forrest LA. Deep neck infection. Otolaryngology Head and Neck Surgery'de Ed.Charles W. Cummings Third Edition, Volume Three, St. Lois, Missouri, 1998;1700-1.
  • Referans4.Goldstein NA, Hammerschlag MR. Peritonsillar, retropharyngeal, and parapharyngeal abscesses. In: Feigin RD, Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez BJ, editors. Textbook of Pediatric Infectious Disease, 8th ed. Philadelphia, PA: Elsevier, 2019. p: 117-23.
  • Referans5. Parhiscar A, Har-El G. Deep neck abscess: A retrospective review of 210 cases. Ann Otol Rhinol Laryngol 2001;110:1051-4.
  • Referans6. Baldassari CM, Howell R, Amorn M, Budacki R, Choi S, Pena M. Complications in pediatric deep neck space abscesses. Otolaryngol Head Neck Surg. 2011;144:592-5.
  • Referans7.Huang TT, Liu TC, Chen PR, Tseng FY, Yeh TH, Chen YS. Deep neck infection: analysis of 185 cases. Head Neck. 2004;26: 854-60.
  • Referans8.Chang L, Chi H, Chiu NC, Huang FY, Lee KS. Deep neck infections in different age groups of children. J Microbiol Immunol Infect. 2010;43:47-52.
  • Referans9.Da Silva PS, Waisberg DR. Internal carotid artery pseudoaneurysm with life-threatening epistaxis as a complication of deep neck space infection. Pediatr Emerg Care. 2011; 27: 422-4.
  • Referans10.Schwartz RH. Infections related to the upper and middle airways. In: Long SS, Pickering LK, Prober CG editors. Pediatric Infectious Diseases. 3rd ed. Churchill Livingstone Elsevier; 2008; p: 213-7.
  • Referans11. Brook I. Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses. J Oral Maxillofac Surg. 2004;62:1545-50.
  • Referans12. Tan PT, Chang LY, Huang YC, Chiu CH, Wang CR, Lin TY. Deep neck infections in children. J Microbiol Immunol Infect. 2001;34:287-92.
  • Referans13. Yang YS, Lee HU, Lee SH, Hong KH. A clinical study of the deep neck infections in children. Korean J Otolaryngol – Head Neck Surg. 2004;47:1282-8. Referans14. Bottin R, Marioni G, Rinaldi R, Boninsegna M, Salvadori L, Staffieri A. Deep neck infection: a present-day complication. A retrospective review of 83 cases (1998-2001). Eur Arch Otorhinolaryngol. 2003;260:576-9.
  • Referans15. Ünsal Tuna EE, Özel E, Özbek C, Özdem C. Derin boyun enfeksiyonu: 63 hastanın incelenmesi. Turk Arch Otolaryngol. 2008;46:73-7. Referans16. Coticchia JM, Getnick GS, Yun RD, Arnold JE. Age-, site-, and time-specific differences in pediatric deep neck abscesses. Arch Otolaryngol Head Neck Surg. 2004;130:201-7.
  • Referans17. Larawin V, Naipao J, Dubey SP. Head and neck space infections. Otolaryngol Head Neck Surg. 2006;135:889-3.
  • Referans18. Kaya EE, Taşar MA, Bilge YD. Evalutıon of deep neck infectionsin pediatric patients. Türkiye Çocuk Hast Derg. 2012;6:197-205.
  • Referans19. Cmejrek RC, Coticchia JM, Arnold JE. Presentation, diagnosis, and management of deep-neck abscesses in infants. Arch Otolaryngol Head Neck Surg. 2002;128:1361-4.
  • Referans20. Belet N, Tapısız A, Uçar Y. Deep neck infections in children. J Pediatr Inf. 2007;1:58-62.
  • Referans21. Metin Ö, Öz FN, Tanır G. Deep neck infections in children: experience in a tertiary care center in Turkey. The Turkish Journal of Pediatrics. 2014;56:272-9.
  • Referans22. Miller WD, Furst IM, Sandor GK, Keller MA. A prospective, blinded comparison of clinical examination and computed tomography in deep neck infections. Laryngoscope 1999;109:1873-9.
  • Referans23. Smith JL, Hsu JM, Chang J. Predicting deep neck space abscess using computed tomography. Am JOtolaryngol. 2006;27:244-7.
  • Referans24. Mayor GP, Millan JMS, Martinez VA. Is conservative treatment of deep neck space infections appropriate? J Head Neck. 2001;23:126-33.
  • Referans25.Goldstein NA, Hammerschlag MR. Peritonsillar,petropharyngeal, and parapharyngeal abscesses. In:Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJeditors. Feigin and Cherry’s Texbook of Pediatric Infectious Diseases. 7th ed. Philadelphia: Elseiver; 2014. p. 167-75.
  • Referans26. Sakaguchi M, Sato S, Ishiyama T, Katsuno S, Taguchi K. Characterization and management of deep neck infections. Int J Oral Max Surg. 1997;26:131-4.
  • Referans27.Wang LF, Kuo WR, Tsai SM, Huang KJ. Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otolaryngol. 2003;24:111-7.
  • Referans28. Eftekharian A, Roozbahany NA, Vaezeafshar R, Narimani N. Deep neck infections: a retrospective review of 112 cases. Eur Arch Otorhinolaryngol. 2009;266:273-7.
  • Referans29. Har-El G, Aroesty JH, Shaha A, Lucente FE. Changing trends in deep neck abscess: a retrospective study of 110 patients. Oral Surg Med. 1994;77:446-50. Referans30. Suehara AB, Gonçalves AJ, Alcadipani FAMC. Deep neck infection: analysis of 80 cases. Rev Bras Otorrinolaringol. 2008;74:253-9.
  • Referans31. Lee JK, Kim HD, Lim SC. Predisposing factors of complicated. Deep neck infection: an analysis of 158 cases. Yonsei Med J 2007;48:55-62.
  • Referans32. Ridder GJ, Technau-Ihling K, Sander A, Boedeker CC. Spectrum and management of deep neck space infections: an 8-year experience of 234 cases. Otolaryngol Head Neck Surg. 2005;133:709-14.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makaleleri
Yazarlar

Berfin Özgökçe Özmen 0000-0001-5054-8507

Mehtap Akça 0000-0002-6397-2320

Edanur Yeşil 0000-0002-8926-9959

Merve Türkegün Şengül 0000-0002-4405-521X

Necdet Kuyucu 0000-0002-6721-4105

Yayımlanma Tarihi 19 Haziran 2023
Gönderilme Tarihi 19 Nisan 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 2 Sayı: 2

Kaynak Göster

APA Özgökçe Özmen, B., Akça, M., Yeşil, E., Türkegün Şengül, M., vd. (2023). Çocukluklarda Derin Boyun Enfeksiyonlarının Değerlendirilmesi: 5 Yıllık Retrospektif Çalışma. İzmir Tıp Fakültesi Dergisi, 2(2), 92-97. https://doi.org/10.57221/izmirtip.1285651
AMA Özgökçe Özmen B, Akça M, Yeşil E, Türkegün Şengül M, Kuyucu N. Çocukluklarda Derin Boyun Enfeksiyonlarının Değerlendirilmesi: 5 Yıllık Retrospektif Çalışma. İzmir Tıp Fak. Derg. Haziran 2023;2(2):92-97. doi:10.57221/izmirtip.1285651
Chicago Özgökçe Özmen, Berfin, Mehtap Akça, Edanur Yeşil, Merve Türkegün Şengül, ve Necdet Kuyucu. “Çocukluklarda Derin Boyun Enfeksiyonlarının Değerlendirilmesi: 5 Yıllık Retrospektif Çalışma”. İzmir Tıp Fakültesi Dergisi 2, sy. 2 (Haziran 2023): 92-97. https://doi.org/10.57221/izmirtip.1285651.
EndNote Özgökçe Özmen B, Akça M, Yeşil E, Türkegün Şengül M, Kuyucu N (01 Haziran 2023) Çocukluklarda Derin Boyun Enfeksiyonlarının Değerlendirilmesi: 5 Yıllık Retrospektif Çalışma. İzmir Tıp Fakültesi Dergisi 2 2 92–97.
IEEE B. Özgökçe Özmen, M. Akça, E. Yeşil, M. Türkegün Şengül, ve N. Kuyucu, “Çocukluklarda Derin Boyun Enfeksiyonlarının Değerlendirilmesi: 5 Yıllık Retrospektif Çalışma”, İzmir Tıp Fak. Derg., c. 2, sy. 2, ss. 92–97, 2023, doi: 10.57221/izmirtip.1285651.
ISNAD Özgökçe Özmen, Berfin vd. “Çocukluklarda Derin Boyun Enfeksiyonlarının Değerlendirilmesi: 5 Yıllık Retrospektif Çalışma”. İzmir Tıp Fakültesi Dergisi 2/2 (Haziran 2023), 92-97. https://doi.org/10.57221/izmirtip.1285651.
JAMA Özgökçe Özmen B, Akça M, Yeşil E, Türkegün Şengül M, Kuyucu N. Çocukluklarda Derin Boyun Enfeksiyonlarının Değerlendirilmesi: 5 Yıllık Retrospektif Çalışma. İzmir Tıp Fak. Derg. 2023;2:92–97.
MLA Özgökçe Özmen, Berfin vd. “Çocukluklarda Derin Boyun Enfeksiyonlarının Değerlendirilmesi: 5 Yıllık Retrospektif Çalışma”. İzmir Tıp Fakültesi Dergisi, c. 2, sy. 2, 2023, ss. 92-97, doi:10.57221/izmirtip.1285651.
Vancouver Özgökçe Özmen B, Akça M, Yeşil E, Türkegün Şengül M, Kuyucu N. Çocukluklarda Derin Boyun Enfeksiyonlarının Değerlendirilmesi: 5 Yıllık Retrospektif Çalışma. İzmir Tıp Fak. Derg. 2023;2(2):92-7.
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