DIAGNOSTIC APPROACHES AND MANAGEMENT OF DEEP NECK SPACE INFECTIONS
Abstract
Deep neck infections (DNI) represent critical medical conditions involving the deep cervical spaces and demand urgent and precise diagnostic measures to prevent severe complications such as airway obstruction, mediastinitis, and sepsis. Accurate and early diagnosis is paramount for effective management and improved patient outcomes. The study has in mind an analysis that provides a component for the efficiency of the medical act and resources, in order to optimize diagnostic strategies and to prevent the occurrence of sepsis. Materials and methods: An observational analytical retrospective study was conducted on a group of 110 patients selected from January 1, 2016 to December 31, 2022. Results: The most frequent clinical presentation was the infection of the lateral cervical space, the frequency of cases being 61 (55.45%), followed by the parapharyngeal and prevertebral locations 24 (21.82%). Considering the laboratory investigations, the white blood cell count was above the normal value with a mean of 15410.1 (SD: 5455). Positive culture was obtained from 61 patients (55.45%). Isolated aerobic bacteria were isolated in 29 (48.3%), gram positive aerobic bacteria were identified in 38 (34.55%), and Gram-negative aerobic bacteria in 8 (7.27%). Nonbacterial culture was observed in 47 patients (42.73%). All 110 patients received intravenous broad-spectrum antibiotics, which were subsequently upgraded based on culture and sensitivity report. Complications were encountered in 46 patients (41.82%). Airway Obstruction was presented by 24 patients (21.82%), and Mediastinitis was found in 31 patients (28.18%) (tab. III). The average number of days of hospitalization in the hospital was 17.3 days (SD: 10.49), and it varied between 2 days and 51 days. Conclusions: Success in the therapy of deep neck infections lies in early and accurate diagnosis, appropriate use of antibiotics, timely surgical intervention when necessary and a multidisciplinary approach to care. This ensures effective infection control and minimizes the risk of complications, ultimately improving patient outcomes.
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