Deep Neck Infection Causing Abscess Formation due to Oral Infectious Disease

Abstract

Deep neck infections cause cellulitis or abscesses to form in the deep neck space. Despite advances in antibiotics, some advanced cases develop mediastinal abscess, sepsis, or disseminated intravascular coagulation, which can be fatal. In this retrospective cohort study, we included 34 patients to examine the factors involved in deep neck abscess severity. We evaluated and compared parameters like sex, age, causative disease, causative site, etc. Patient age was 8–78 years, with a higher proportion of males（24 cases; 70.6%）than females（10 cases; 29.4%）. The causative tooth of the 31 cases of odontogenic infection（excluding three cases of osteomyelitis of jaw and peri-implantitis）was a mandibular molar in 30 cases（96.8%）and maxillary molar in one case（3.2%）. Overall, the mean（± standard deviation）hospital stay was 22.7±20.3 days and was longer for females（31.0±20.3 days）than for males（19.2±19.6 days）. C-reactive protein （CRP）levels were significantly correlated with hospital stay duration. Multivariate analysis revealed that patients with an abscess in the masticator, parapharyngeal, or anterior visceral space had significantly longer hospital stays. Patients with actinomycetes had significantly longer hospital stays. No significant differences in hospital stay were noted based on whether the patient was a compromised host. This study suggests that CRP levels, abscess location, and existence of actinomycete infection contribute to the severity of deep neck abscess.