Surgical management of lateral neck abscesses in children-a retrospective analysis of 100 cases

Background Cervical abscesses are relatively common infections in pediatric patients. There is an ongoing debate, primarily initiated by pediatricians, about necessity and time point of surgical drainage. The identification of a focus of infection can play an important role in facilitating a therapeutic decision.

Methods In a retrospective case-control study 100, pediatric patients aged 1-18 years who underwent incision and drainage of a lateral cervical abscess at our institution were analyzed. Patients were divided into two groups based on whether a focus of infection could be identified or not. Data collection included patient characteristics, microbiological results, antibiotic regimen and clinical course.

Results A focus of infection was found in 29 %  of the patients, most frequently in the tonsils. A causative microorganism was found in 76 %  of all patients, with Staphylococcus aureus and Streptococcus pyogenes being the most common pathogens. All patients received an initial empiric antibiotic therapy. A change of antibiotic therapy was necessary in 30 %  in both groups. Children without an identified focus of infection generally were younger, had more comorbidities reducing immune response while also showing differences in the pathogens involved. There were no complications associated to surgery or antibiotic therapy in any of the patients involved.

Conclusions Children with an identified focus of infection show several differences compared to those with isolated lateral abscesses, especially regarding the microorganisms involved. Surgical drainage not only reduces the duration of infection but also provides important information regarding microbacterial findings. Thus, we strongly recommend surgical drainage in all patients with cervical abscesses.

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Conflict of interest

Der Erstautor gibt keinen Interessenskonflikt an.

Publication History

Article published online:
13 May 2021