How Do Deep Neck Infections Present?
Discussion
Deep neck space infections (DNSI) are not very common (estimated to be 4.6/100,000) but extremely important to have a high index of suspicion for.
The anatomy of DNSs is complex and covered by substantial amounts of superficial soft tissue making diagnosis difficult.
Additionally, children often cannot give more precise or accurate histories and can be difficult to examine> Most infections in children are in those < 6 years.
Lying within or adjacent to the DNS are numerous bones, blood vessels, nerves and other soft tissues. The spaces communicate between each other and therefore spreading can also occur including into the chest.
Complications of DNSI include:
Airway compromise
Jugular vein thrombosis (Lemierre’s syndrome)
Mediastinitis
Neural dysfunction
Osteomyelitis
Sepsis
Vascular erosion
In pediatric patients, the usual cause is pharyngitis or tonsillitis, whereas in adult patients the usual cause is odontogenic. However it is important to note that there are substantial numbers of cases (20-50%) that the etiology is not identified. Fortunately, DNSIs are less common because of antibiotics for treatment of respiratory illnesses and odontogenic problems.
Other causes of DNSIs include:
Cervical lymphadenitis
Congenital anomalies
Branchial cleft
Thyroglossal duct cysts
Foreign body
Trauma
Instrumentation – bronchoscopy, esophagoscopy
Intravenous drug use
Salivary gland obstruction or infection
Laryngopyocele
Mastoiditis
Thyroiditis
Malign...
Source: PediatricEducation.org - Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
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