Kwon Minsu, Seo Ji-Hyun, Cho Ki Ju, Won Seong Jun, Woo Seung Hoon, Kim Jin Pyeong, Park Jung Je
Department of Otorhinolaryngology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
Departments of Pediatrics, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Gangnam-ro Jinju, Republic of Korea.
Ann Otol Rhinol Laryngol. 2016 Dec;125(12):953-958. doi: 10.1177/0003489416665194. Epub 2016 Aug 23.
The indications and benefits of surgery in the management of pediatric acute suppurative cervical lymphadenitis (ASCL) remain unclear. We aimed to design a management protocol focusing on the avoidance of unnecessary operation in pediatric ASCL patients.
The study population consisted of 45 pediatric patients with ASCL treated with antibiotics alone and 30 surgically treated patients. The primary outcome was the determination of differences in patient characteristics and radiologic findings in the 2 groups. The secondary outcome, after matching 20 cases with 20 controls, was to determine the benefits of surgery to patients.
There were no significant differences between the 2 groups in patient characteristics and radiologic findings at initial presentation. In the matched case-control analysis, intravenous antibiotics alone yielded successful treatment outcomes when compared with surgery, with no significant differences in time to symptom resolution, normalized laboratory test results, and duration of hospitalization (all P > .05).
The size and location of suppurated lymph nodes are not absolute determinants for surgical drainage in the stable pediatric ASCL patients. If patients show no clinical improvements despite appropriate second- and third-line antibiotics, patients should be carefully reevaluated and image-guided aspiration considered.
