Abstract
This study is intended to analyze the clinical profile and outcomes of deep neck space infection in diabetic patients in our tertiary care centre. A prospective study of 1 year duration from 30th September 2015 to 30th September 2016 at department of Otorhinolaryngology, Gauhati Medical College and Hospital, Guwahati. A total of 45 diabetic patients who presented with DNSI are included in this study. Their demographic profile, etiology, bacteriology, treatment, duration of hospital stay, complications and outcomes have been analyzed. 45 patients were recorded; 32 (71.11%) were men, and 13 (45%) were women, with a mean age of 63.27 ± 7.55 years. There were 30 patients (66.67%) who had associated systemic diseases apart from diabetes mellitus. The parapharyngeal space in 13 patients (28.89%) was the most commonly involved space. Odontogenic infections in 18 patients (40%) and upper airway infections 9 patients (20%) were the two most common causes. Klebsiella pneumonia in 29 patients (64.44%), was the commonest organism isolated through pus cultures. All the patients except one (97.78%) came with abscess and underwent surgical drainage. One patient (2.22%) with carbuncle underwent regular dressing. Six patients (13.33%) had major complications. Those patients with other underlying systemic diseases or complications tended to have a longer hospital stay and were older. No cases of death has been reported. (mortality rate, 0%). DNSI patients with diabetes have a more severe clinical course. They are likely to have complications more frequently and a longer duration of hospital stay. In clinical practices while dealing with these patients more vigilance is required. On admission empirical antibiotics should cover K. pneumonia. Early surgical drainage remains the main method of treatment. Primary prevention can be achieved by orodental hygiene, regular dental check ups and in this part of the country by avoidance of substance abuse like tobacco chewing.
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Abbreviations
- DNSI:
-
Deep neck space infections
- DM:
-
Diabetes mellitus
References
Vieira F, Allen SM, Stocks RSM, Thompson JW (2008) Deep neck infections. Otolaryngol Clin N Am. 12:459–483
Poeschl PW, Spusta L, Russ Mueller G, Seemann R, Hirschl A, Poeschl E et al (2010) Antibiotic susceptibility and resistance of the odontogenic microbiological spectrum and its clinical impact on severe deep space head and neck infections. Oral Surge Oral Med, Oral Pathol, Oral Radiol Endod 110(2):151–156
Kang SK, Lee S, Oh HK, Kang MW, Na MH, Yu JH, Koo BS, Lim SP (2012) Clinical features of deep neck infections and predisposition factorsfor mediastinal extension. Korean J Thorac Cardiovasc Surg 45(3):171–176. doi:10.5090/kjtcs.2012.45.3171
Weed H, Forest L (1998) Deep neck infection. J Otolaryngol Head Neck Surg 3:2515–2524
Parhiscar A, Harel G (2011) Deep neck abscess: a retrospective review of 210 cases. Ann Otolo Rhinol Laryngol 110(11):1051–1054
Murray AD Deep neck space infections. http://emedicine.medscape.com/article/837048-overview
Wang LF, Kuo WR, Tsai SM, Huang KJ (2003) Characterizations of life threatening deep cervical space infections: a review of one hundred ninety six cases. Am J Otolaryngol 24(2):111–117
Huang TT, Liu TC, Chen PR et al (2004) Deep neck infection: analysis of 185 cases. Head Neck 26:854–860
Logan turner’s diseases of the nose, throat and ear and head and neck surgery; neck space infections. 11th edn., p 277
Cummings otolaryngology, deep neck space infections and head and neck surgery, 5th edn
Lee JK, Kim HD, Lim SC (2007) Predisposing factors of complicated deep neck infection: an analysis of 158 cases. Yonsei Med J 48(1):55–62
Meher R, Jain A, Sabharwal A, Gupta B, Singh I, Agarwal I (2005) Deep neck abscess: a prospective study of 54 cases. J Laryngol Otol 119(04):299–302
Sethi DS, Stanley RE (1994) Deep neck abscesses-changing trends. J Laryngol Otol 108:138–143
Anil S, Al-Ghamdi HS (2006) The impact of periodontal infections on systemic diseases. AN update for medical practitioners. Saudi Med J 27(6):767–776
Wong TY (1999) A nationwide survey of deaths from oral and maxillofacial infections: the Taiwanese experience. J Oral Maxillofac Surg 57:1297–1299
Tschiassny K (1943) Ludwig’s angina: an anatomic study of the role of the lower molar teeth in its pathogenesis. Arch Otolaryngol 38(5):485–496
Khode SR, Bhat P, Rane S, Dasguota KS (2013) Retrospective analysis of 298 cases of deep neck infections: its diagnosis and management. Sci J Med Clin Trials 103:1–3
Yonetsu K, Izumi M, Nakamura T (1998) Deep facial infections of odontogenic origin: CT assessment of pathways of space involvement. AJNR Am J Neuroradiol 19:123–128
Delamaire M, Maugendre D, Moreno M et al (1997) Impaired leukocyte functions in diabetic patients. Diabetic Med 14:29–34
Har-El G, Aroesty JH, Shaha A, Lucente FE (1994) Changing trends in deep neck abscess. A retrospective study of 110 patients. Oral Surg OralMed Oral Pathol 77:446–450
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Sharma, K., Das, D., Joshi, M. et al. Deep Neck Space Infections-A Study in Diabetic Population in a Tertiary Care Centre. Indian J Otolaryngol Head Neck Surg 70, 22–27 (2018). https://doi.org/10.1007/s12070-017-1196-0
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DOI: https://doi.org/10.1007/s12070-017-1196-0