Chen Shih-Lung, Young Chi-Kuang, Liao Chun-Ta, Tsai Tsung-You, Kang Chung-Jan, Huang Shiang-Fu
Department of Otorhinolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou 333, Taiwan.
School of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Microorganisms. 2021 Nov 15;9(11):2361. doi: 10.3390/microorganisms9112361.
Deep neck infections (DNIs) such as parotid abscesses are medical emergencies with a seemingly different etiology and treatment course from other DNIs. We sought to confirm this in the present retrospective population-based cohort study. Between August 2016 and January 2020, 412 patients with DNIs seen at a tertiary medical center were enrolled in this study. Infections of the parotid space were compared with those of other deep neck spaces, according to patient characteristics. All patients were divided into parotid space (PS; = 91, 22.08%) and non-parotid space (NPS; = 321, 77.92%) subgroups. We further divided the patients into single parotid space (PS-single; = 50, 12.13%), single non-parotid space (NPS-single; = 149, 36.16%), multiple parotid space (PS-multiple; = 41, 9.95%), and multiple non-parotid space (NPS-multiple; = 172, 41.76%) DNI subgroups. In the PS-single and PS-multiple subgroups, a longer duration of symptoms ( = 0.001), lower white blood cell count ( = 0.001), lower C-reactive protein level ( = 0.010), higher rate of ultrasonography-guided drainage ( < 0.001), and lower rates of surgical incision and drainage ( < 0.001) were observed compared with the NPS-single and NPS-multiple subgroups. The PS group had a higher positive culture rate ( < 0.001), and lower positive ( = 0.002), and ( = 0.025) culture rates than the NPS group. In a multivariate analysis, was independently associated with parotoid space involvement in comparisons of the PS and NPS groups, PS-single and NPS-single subgroups, and PS-multiple and NPS-multiple subgroups. The clinical presentation of a parotid space infection differs from that of other deep neck space infections.
诸如腮腺脓肿之类的深部颈部感染（DNIs）属于医疗急症，其病因和治疗过程似乎与其他DNIs有所不同。我们试图在这项基于人群的回顾性队列研究中证实这一点。2016年8月至2020年1月期间，在一家三级医疗中心就诊的412例DNIs患者被纳入本研究。根据患者特征，将腮腺间隙感染与其他深部颈部间隙感染进行比较。所有患者被分为腮腺间隙（PS；n = 91，22.08%）和非腮腺间隙（NPS；n = 321，77.92%）亚组。我们进一步将患者分为单腮腺间隙（PS-单；n = 50，12.13%）、单非腮腺间隙（NPS-单；n = 149，36.16%）、多腮腺间隙（PS-多；n = 41，9.95%）和多非腮腺间隙（NPS-多；n = 172，41.76%）DNI亚组。与NPS-单和NPS-多亚组相比，在PS-单和PS-多亚组中，观察到症状持续时间更长（P = 0.001）、白细胞计数更低（P = 0.001）、C反应蛋白水平更低（P = 0.010）、超声引导下引流率更高（P < 0.001）以及手术切开引流率更低（P < 0.001）。PS组的培养阳性率更高（P < 0.001），而培养阳性率（P = 0.002）和 （P = 0.025）低于NPS组。在多变量分析中，在PS与NPS组、PS-单与NPS-单亚组以及PS-多与NPS-多亚组的比较中， 与腮腺间隙受累独立相关。腮腺间隙感染的临床表现与其他深部颈部间隙感染不同。
