Department of Otorhinolaryngology and Head and Neck Surgery, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
Kathmandu Univ Med J (KUMJ). 2021;19(73):57-61.
Background Deep neck infections are severe infections in potential spaces and fascial planes of the neck. Despite antibiotic therapy, these infections continue to cause significant morbidity and mortality. Objective To determine the clinical features, predisposing factors, socio demographic factors and complications associated with deep neck infections. Method Prospective study conducted in the Department of Otorhinolaryngology, Kathmandu University Dhulikhel Hospital between March 2018 and June 2020. Seventy-five patients with deep neck infections were enrolled. Result Submandibular abscess was most frequently observed (41.3%), followed by submental abscess (25.3%), parotid abscess(9.3%), ludwig's angina (6.7%), posterior triangle of neck abscess (4%), retropharyngeal abscess (2.7%), parapharyngeal space abscess (2.7%), and multiple space infections (8%). Staphylococcus aureus was the most common organism (53.3%), followed by Beta hemolytic Streptococcus (12%) and methicillin-resistant Staphylococcus aureus (12%). A negative culture was seen in 22.7%. Sixty-eight percent of patients underwent incision and drainage. Incision and drainage with dental extraction was done in 26.7%, four percent underwent incision and drainage with debridement and dental extraction, whereas 1.3% underwent incision and drainage with tracheostomy. Eight percent patients required Intensive care unit admission. Seven patients had descending mediastinitis, four out of which developed sepsis. When age and duration of hospital stay were correlated by using Pearson correlation coefficient, a remarkable correlation was observed (p=.020). Noteworthy relationship was not observed between different locations of deep neck infections and duration of hospital stay (p=.202). Conclusion Early identification of deep neck infections is often challenging. Proper knowledge and extreme vigilance is necessary when dealing with these complex entities to avoid life-threatening complications.
深部颈部感染是颈部潜在间隙和筋膜平面的严重感染。尽管进行了抗生素治疗，但这些感染仍然导致显著的发病率和死亡率。
确定深部颈部感染的临床特征、易患因素、社会人口学因素和并发症。
在 2018 年 3 月至 2020 年 6 月期间，在加德满都大学 Dhulikhel 医院耳鼻喉科进行了一项前瞻性研究。共纳入 75 例深部颈部感染患者。
最常观察到的是下颌下脓肿（41.3%），其次是颏下脓肿（25.3%）、腮腺脓肿（9.3%）、路德维希咽峡炎（6.7%）、颈后三角脓肿（4%）、咽后脓肿（2.7%）、咽旁间隙脓肿（2.7%）和多个间隙感染（8%）。金黄色葡萄球菌是最常见的病原体（53.3%），其次是乙型溶血性链球菌（12%）和耐甲氧西林金黄色葡萄球菌（12%）。22.7%的患者培养结果为阴性。68%的患者接受了切开引流术。26.7%的患者行切开引流加拔牙，4%的患者行切开引流加清创加拔牙，1.3%的患者行切开引流加气管切开术。8%的患者需要入住重症监护病房。7 例患者发生下行性纵隔炎，其中 4 例发生脓毒症。用 Pearson 相关系数对年龄和住院时间进行相关性分析时，观察到显著相关性（p=.020）。然而，深部颈部感染的不同部位与住院时间之间未观察到显著关系（p=.202）。
深部颈部感染的早期识别通常具有挑战性。在处理这些复杂实体时，需要有适当的知识和高度的警惕性，以避免危及生命的并发症。
