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Paediatric neck abscesses: microbiology and management

Published online by Cambridge University Press:  11 June 2007

I K Rustom ,
J A T Sandoe  and
Z G G Makura
I K Rustom*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Leeds General Infirmary, UK
J A T Sandoe
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Leeds General Infirmary, UK
Z G G Makura
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Leeds General Infirmary, UK
*
Address for Correspondence: Mr Isam Rustom, 8 Sycamore Close, Meanwood, Leeds LS7 2UN, UK. Fax: +44113 392 3165, E-mail: isamrustom@hotmail.com
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Abstract

Introduction:

Paediatric neck abscesses remain common problems which are sometimes difficult to manage.

Methods and materials:

We conducted a retrospective study of 64 children who underwent incision and drainage of neck abscesses at Leeds General Infirmary from 1 February 2002 to 31 July 2006. The aim of this study was to identify the presenting symptoms in children, the appropriateness of prescribed antibiotics and the role of atypical mycobacteria in neck infections. The outcome measure was clinical resolution of the abscess.

Results:

The mean presenting age was 44.2 months (3.68 years). The commonest sign and symptom was neck mass (96.9 per cent). The mean period of hospitalisation was 3.7 (± standard deviation of 1.9) days. Staphylococcus aureus (48.4 per cent) was the commonest organism cultured. Atypical mycobacteria were found in only 4.7 per cent of the specimens. Flucloxacillin was the most common antibiotic used (57.8 per cent), often in combination with other antimicrobials. The abscess recurrence rate was 4.7 per cent. No fatalities occurred in this series of patients.

Conclusion:

Appropriately prescribed intravenous antibiotics and surgical drainage remain the central core of treatment. Atypical mycobacterial infection is an important differential diagnosis of a painless, cervico-facial mass. An algorithm for the management of paediatric neck abscesses is proposed.

Keywords

Head and NeckAbscessChildren

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 5 , May 2008 , pp. 480 - 484
Copyright
Copyright © JLO (1984) Limited 2007

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