Deep Neck Infection in Adults: Factors Associated with Complicated Treatment Outcomes
Surapol Suetrong MD*, Wisoot Reechaipichitkul MD*, Seksun Chainansamit MD*, Patorn Piromchai MD*
Affiliation : * Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective : 1) describe clinical characteristics of deep neck infection (DNI) and 2) evaluate associations between clinical risk-
factors and complicated treatment outcomes of DNI in adults.
Material and Method: Eighty-nine consecutive medical records of DNI patients, older than 18 years of age, at a university
hospital between January, 2009 and December, 2015 were retrospectively reviewed. Studied clinical data were collected and
recorded. Descriptive statistics were reported as mean, frequency or percentage. Analytical statistics (Fisher’s exact test and
Odds ratio) were used to identify associations between categorical variables.
Results : Patients’ ages ranged between 22-89 years (mean of 51.3 + 16.6 years). Diabetes mellitus was the most common
comorbidity (31.5%). Dental origin was the most common etiology (60.7%). Streptococcus viridans group was the most
common causative organism (27.8%), followed by Burkholderia pseudomallei (22.2%). Surgical drainage was performed in
70.2% of cases. Among all complications (22.5%), airway obstruction was the most common (15.7%). Co-morbidities,
Dyspnea, fever, retropharyngeal DNI, visceral-vascular space DNI, multiple space DNI, need for surgical drainage, and
prolonged hospitalization were significantly associated with complications. Fever, visceral-vascular space, multiple space
DNI and prolonged hospital stays were significantly associated with surgery required DNI. Parapharyngeal, retropharyngeal,
visceral-vascular spaces and prolonged hospital stays were significantly related to multiple space DNI. The respective risks
for complications and multiple space involvement in melioidosis DNI patients were 2.44-fold and 2.28-fold higher than those
of other DNI patients
Conclusion : Complicated treatment outcomes of DNI in adults including complications, need for surgical drainage and
prolonged hospitalization had significant associations with comorbidities, fever, dyspnea, multiple space DNI, parapharyngeal,
retropharyngeal DNI and visceral-vascular spaceDNI. Melioidosis should be suspected in cases of severe DNI, especially if
patients originating from or returning from travel in endemic areas
Keywords : Deep neck infection, Complications, Risk factors, Treatment, Adult
