Clinical Study of Deep Neck Infection

Do, Nam Yong; Cho, Sung Il; Lee, Jun Han; Dong, Geun Woo; Kim, Gun Hyung

Abstract

BACKGROUND AND OBJECTIVES
The incidence of deep neck infection has decreased after the introduction of antibiotics and improvement of oral hygiene, but it may still be lethal especially when life-threatening complications occur. The objective of this study is to clarify the presenting signs and symptoms, clinical course, microorganisms, and management of deep neck infections.
SUBJECTS AND METHOD
We retrospectively reviewed the records of 134 patients who were diagnosed with deep neck infection and who received treatment at the Chosun University Hospital between 1996 and 2005 for the analysis of age and sex, distribution related to spaces involved, the location of cellulitis and abscess, the side of lesion, the symptoms and signs, the etiologic events, the associated conditions, the result of culture, and the treatments. Peritonsillar abscesses were excluded from this study.
RESULTS
The parapharyngeal space and extended space were the most commonly involved space of deep neck infections, followed by submandibular space, retropharyngeal space, and Ludwig's angina. The most common pathogens found were Streptococcus, followed by Klebsiella and Staphylococcus. In diabetic patients, Klebsiella pneumoniae was the most common causative pathogen. Peptostreptococcus was the most common anaerobic pathogen.
CONCLUSION
Initial management including trial of proper empirical antibiotics is important. According to the culture and antibiotic sensitivity test in this study, a combined therapy of amoxicillin/clavulanic acid and metronidazole is useful in polymicrobial deep neck infection.