Salem Ahmed Algerza, Mostafa Ibrahim Ammar, Ahmed Samy Elguindy and Hossam Sayed Gamil Elsherif
Background: Acute neck infection in children is a relatively common presentation to otolaryngologists in emergency setting that always requires prompt intervention to avoid life-threatening complications. The aim of the study was to evaluate the conservative management strategy for management of paediatric neck infection we adopted during the COVID-19 pandemic.
Methods: This Prospective study that was carried out on 34 Patients aged from 1 to 12 years old presented with acute neck infection that was not amenable or did not respond to simple oral outpatient treatment. Patient were categorized into conservative group received IV medical treatment for 48 hours. The Aspiration group had neck Ultrasound (US) guided aspiration of the residual collection after medical treatment. The Incision& Drainage group in which medical treatment and ultrasound guided aspiration were insufficient.
Results: More than half of our patients (53%) were successfully managed in a conservative way. Other patients (29%) were treated with minimally invasive fashion in the firm of US guided aspiration, and the remaining patients (18%) underwent Incision and drainage under general anaesthesia. There was significant reduction in total leukocyte count (TLC) and C-reactive protein (CRP) after 48 hrs of medical treatment in the different groups. We can’t rely on the value of TLC or CRP as cut-off point to determine the presence of drainable collection or not. But it can be used as follow up marker.
Conclusions: In a stable patient with acute neck infections, intravenous antibiotic treatment with corticosteroids is a good and safe alternative to surgical drainage. Ultrasonography is of good value in evaluating non complicated cases of acute neck infection.
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