Division of Pediatric Otolaryngology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
Otolaryngol Head Neck Surg. 2013 Jun;148(6):1037-42. doi: 10.1177/0194599813482292. Epub 2013 Mar 21.
To identify clinical features associated with unsuccessful medical therapy in children with deep space neck infections (DSNIs).
Consecutive case series with chart review.
Tertiary-care, academic children's hospital.
One hundred seventy-eight pediatric patients treated for retropharyngeal or parapharyngeal infections between July 1, 2007, and May 23, 2012.
Median age was 34.5 months (2.9 years; range, 2-142 months); two-thirds were male. Increased surgical drainage was found in children age ≤ 15 months (P = .002) and for abscesses >2.2 cm (P = .0001). Risk factors associated with increased likelihood of medical therapy failure included age ≤ 51 months, intensive care unit admission, and computed tomography findings consistent with abscess size >2.2 cm. Methicillin-resistant Staphylococcus aureus infections were found more often in younger children, with the highest incidence in those ≤ 15 months of age (P = .001). All children had resolution of infection.
Deep space neck infections in children can often be successfully managed with medical therapy alone, but life-threatening complications may occur. We recommend that young patients be managed cautiously.
确定与儿童深部间隙颈部感染（DSNIs）药物治疗失败相关的临床特征。
连续病例系列，结合图表回顾。
三级保健，学术儿童医院。
2007 年 7 月 1 日至 2012 年 5 月 23 日期间，对 178 例接受治疗的咽后或咽旁感染的儿科患者进行了研究。
中位年龄为 34.5 个月（2.9 年；范围，2-142 个月）；三分之二为男性。≤15 个月的儿童（P=.002）和脓肿>2.2cm 的儿童（P=.0001）发现需要增加手术引流。与药物治疗失败风险增加相关的危险因素包括年龄≤51 个月、入住重症监护病房以及 CT 检查发现脓肿大小>2.2cm。耐甲氧西林金黄色葡萄球菌感染在年龄较小的儿童中更为常见，其中≤15 个月的儿童发病率最高（P=.001）。所有儿童的感染均得到了治愈。
儿童深部间隙颈部感染通常可以单独通过药物治疗成功治疗，但可能会发生危及生命的并发症。我们建议谨慎治疗年轻患者。
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