J Korean Soc Emerg Med.  2008 Oct;19(5):576-581.

Clinical Variables Indicating Cervical Abscess in Adult Patients Diagnosed with Deep Neck Infection

• Jeong WJ
• Lee HY
• Lee WS
• Han SK
• Kim IS
• Ryu S
• Lee JW
• Kim SW
• Yoo IS
• You YH

Abstract

PURPOSE: We evaluated a method to distinguish group A (abscess) from group B (cellulitis, pharyngitis, tonsillitis, epiglottis) through clinical variables in patients with a deep neck infection.
METHODS
This was a retrospective chart review study consisting of the evaluation of CT scans or surgical diagnoses on adult patients (18 or more years of age). CT scans were reviewed by a radiologist. We evaluated several clinical variables in order to distinguish group A from group B. We also evaluated the ability of these clinical variables to distinguish group A from group B by a receiver operating characteristic curve.
RESULTS
Sixty-three patients were enrolled in this study. Several clinical variables (swelling, odynophagia, tenderness, trismus, age>50years) differed between group A and group B. A AUC which was obtained by adding the number of variables (swelling, odynophagia, tenderness, trismus, age>50years) was 0.87 (p<0.01). The sensitivity and specificity of these clinical variables were 0.96 and 0.6 respectively, when the cut off value for adding the number of variables was set as 1.5. When the sum of these number of variables are more than two, the sensitivity is 0.958 (95% C.I:0.901~0.987) and the specificity is 0.600 (95% C.I:0.417~0.693).
CONCLUSION
Five clinical variables (age>50, swelling, odynophagia, tenderness, trismus) were able to distinguish group A from group B.

Keyword

Neck; Soft tissue infections; Abscess; Risk assessement

MeSH Terms

Abscess
Adult
Area Under Curve
Humans
Neck
Palatine Tonsil
Pharyngitis
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Soft Tissue Infections
Tonsillitis
Trismus