Deep Neck Infections. Review of 111 cases.

Abstract

<b>Introduction:</b> Deep neck infections (DNI) are potentially life-threatening conditions. The infections are commonly polymicrobial, and develop as a result of oral cavity infections, tonsilitis, laryngitis, trauma, or malignancy. Timely diagnostics and management are essential to prevent severe complications such as airway obstruction, sepsis or mediastinitis. Our study highlights the clinical characteristics of DNI etiology, complications, and treatment outcomes.<b>Aim:</b> This study aimed to provide a structured overview of a cohort of 111 patients with deep neck infection, comprising patient characteristics, etiology, clinical imaging, and complications along with the prognosis according to the used therapeutic strategy.<b>Methods:</b> This is a retrospective analysis of 111 patients who were hospitalized with DNI. We evaluated the demographics, clinical presentation, microbiological findings, and treatment outcomes. Statistical analyses including Pearson's chi-square, Mann-Whitney U test, independent-samples Kruskal-Wallis test and binary logistic regression were used to asses our data.<b>Results:</b> There was a predominance of male patients (62.2%) in our cohort. We found an increased DNI incidence over life in the middle-to-older age groups. The median patient age was 53 for male patients and 55 for female patients. The median hospital stay in our study was 10 days. Odontogenic infections were the leading etiology (37.8%), followed by complications of tonsillitis (23.4%) and phlegmonous laryngitis (12.6%). As many as 38.7% of patients had the following complications: airway obstruction in 25.2%, mediastinitis 10.8%, and sepsis 5.4%. The most commonly used antibiotics were ceftriaxone + metronidazole (28.8%) and amoxiclav (13.5%). The most common bacterium found in swab cultures was Streptococcus constellatus, and complications were more common in patients with a positive culture for <i>Acinetobacter baumannii</i>. Antibacterial resistance was found in 28.8% of the specimens. There was a significant association between antibiotic resistance and complication rates (P<0.05).