Deep neck infections - still important diagnostic and therapeutic problem

Olejniczak, Izabela; Bojanowska-Poźniak, Katarzyna; Pietruszewska, Wioletta

doi:10.5604/00306657.1200650

Cited by 2 publications

(2 citation statements)

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“…The anatomy of the deep cervical space is quite complicated given that it is surrounded by multiple layers of cervical fasciae [ 15 ]. Therefore, identifying infections in the deep cervical space remains challenging, especially during the early localized stage [ 16 ]. In addition, it is even harder to accurately assess the extent and severity of infections, which is essential in making prompt decisions regarding surgical intervention versus observation with IV antibiotics [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Initial Nutritional Status and Clinical Outcomes in Patients with Deep Neck Infection

Park

Kim

et al. 2018

Clin Exp Otorhinolaryngol

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ObjectivesThe current study aims to determine the correlation between nutritional status upon presentation and disease severity, as well as treatment and survival outcomes.MethodsPatients who were diagnosed with deep neck infection, underwent at least one surgical drainage/debridement, and had more than 1 week of hospitalization at a tertiary medical center from 2007 to 2015 were retrospectively included. Thereafter, initial serum albumin, C-reactive protein (CRP), and body mass index (BMI) were reviewed.ResultsA total of 135 patients were included in the final analysis. Accordingly, the proportion of patients with simultaneous mediastinitis (21.0%), necrotizing fasciitis (12.9%), disease extent >1 cervical level (72.6%), mean CRP (22.4 mg/dL), mean length of hospitalization (25.0 days), and mean 1-week follow-up CRP (7.2 mg/dL) was significantly higher in the hypoalbuminemia group (initial serum albumin <3.0 g/dL) than in the normoalbuminemia group (all P<0.05). No significant correlations had been observed according to BMI status. After adjusting for age and Charlson comorbidity index, odds ratios for the following outcomes were calculated in patients initially presenting with hypoalbuminemia: simultaneous mediastinitis (3.07), necrotizing fasciitis (7.89), disease extent >1 cervical level (2.12), initial serum CRP over 20 mg/dL (3.79), hospitalization of more than 14 days (4.10), 1-week follow-up CRP over 5 mg/dL (3.78), and increased duration for an over 50% decrease in initial CRP (2.70) (all P<0.05). Although intravascular albumin replenishment decreased the proportion of patients with hypoalbuminemia after 2 weeks (P<0.05), it did not significantly predict better treatment outcomes.ConclusionAmong the markers reflecting an individual’s nutritional state, an initial serum albumin of less than 3.0 g/dL was an independent serologic marker predicting increased disease severity and complications in patients with deep neck infection.

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Section: Discussionmentioning

confidence: 99%

Initial Nutritional Status and Clinical Outcomes in Patients with Deep Neck Infection

Park

Kim

et al. 2018

Clin Exp Otorhinolaryngol

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“…Deep neck abscesses can lead to complications such as mediastinitis, airway obstruction, empyema, and sepsis, causing death [1][2][3] . They occur more frequently in males 4,5 (55.63%)and at an average age of 40 years 6,7 . The characteristic symptoms consist of fever, increased volume, general malaise, dysphagia, trismus, dysphonia, and dyspnea 1,7 .…”

Section: Introductionmentioning

confidence: 99%

Association of the Moore sign with the presence of deep neck abscess of retropharyngeal space

Ruiz-Ruiz,

García-Covarrubias,

Romero-Gameros

et al. 2024

CIRUE

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Background: Deep neck abscesses can cause life-threatening complications. They are diagnosed by physical examination, and contrasted tomography as the gold standard. There are no studies about the association of Moore's sign with infections of the retropharyngeal space. Objective: To determine the usefulness of Moore's sign in the diagnosis of deep retropharyngeal abscess. Method: Observational, analytical, cross-sectional, study of patients with deep neck abscess, from May 1, 2019, to August 30, 2021, with report of Moore's sign. Results: 87 patients were included, 49 (56.3%) males (p = 0.45). Of those who developed complications, 77.8% had a negative Moore's sign (p = 0.001). Of those admitted to the ICU, 72% had a negative Moore's sign (p = 0.001). The sensitivity of the absence of the sign with retropharyngeal involvement was 95.4%, and the specificity was 86.3%. By logistic regression, it was found that those with retropharyngeal involvement are 467 times more likely to present a negative sign (p < 0.05). Conclusions: The presence of abscess in the retropharynx is associated with complications and a worse prognosis. The evaluation of Moore's sign can be a useful tool to suspect compromise of this space.

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Deep neck infections - still important diagnostic and therapeutic problem

Cited by 2 publications

References 0 publications

Initial Nutritional Status and Clinical Outcomes in Patients with Deep Neck Infection

Initial Nutritional Status and Clinical Outcomes in Patients with Deep Neck Infection

Association of the Moore sign with the presence of deep neck abscess of retropharyngeal space

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