Peritonsillar and deep neck infections: a review of 330 cases

Abstract Introduction: Deep neck infections are defined as suppurative infectious processes of deep visceral spaces of the neck. Objective: The aim of this study is to review different factors that may influence peritonsillar and deep neck infections and may play a role as bad prognosis predictors. Methods: We present a retrospective study of 330 patients with deep neck infections and peritonsillar infections who were admitted between January 2005 and December 2015 in a tertiary referral hospital. Statistical analysis of comorbidities, diagnostic and therapeutic aspects was performed with Excel and SPSS. Results: There has been an increase in incidence of peritonsilar and deep neck infections. Systemic comorbidities such as diabetes or hepatopathy are bad prognosis factors. The most common pathogen was S. viridans (32.1% of positive cultures). 100% of the patients received antibiotics and corticosteroids, 74.24% needed surgical treatment. The most common complications were mediastinitis (1.2%) and airway obstruction (0.9%). Conclusion: Systemic comorbidities are bad prognosis predictors. Nowadays mortality has decreased thanks to multidisciplinary attention and improvements in diagnosis and treatment.

摘要：颈深部感染（Deep neck infections）是指发生于颈部深部内脏间隙的化脓性感染性病变。本研究旨在梳理可影响扁桃体周围感染及颈深部感染发生、并可作为不良预后预测因素的各类相关因素。方法：本研究为回顾性研究，纳入2005年1月至2015年12月期间于某三级转诊医院收治的330例颈深部感染及扁桃体周围感染患者。采用Excel及SPSS软件对患者合并症、诊断与治疗相关情况进行统计学分析。结果：扁桃体周围感染及颈深部感染的发病率呈上升趋势。糖尿病、肝病等全身性合并症为不良预后危险因素。最常见的病原菌为草绿色链球菌（S. viridans），占阳性培养结果的32.1%。所有患者均接受了抗生素及糖皮质激素治疗，其中74.24%的患者需行外科手术治疗。最常见的并发症为纵隔炎（1.2%）及气道梗阻（0.9%）。结论：全身性合并症可作为不良预后的预测因素。得益于多学科诊疗以及诊断与治疗技术的进步，当前该病的死亡率已有所下降。