Abstract
Objective
To test the hypothesis that children with less than 48 hours of localized symptoms of deep space neck infections are less likely to have an abscess on CT than children with at least 48 hours of localized symptoms.
Methods
Children seen in a tertiary hospital between 2000 and 2007 with infections of the head and neck region, excluding peritonsillar abscess, were identified. Data regarding presentation, physical exam findings, radiographic findings, and treatment were extracted.
Results
Of 179 children identified, 167 (93.3%) underwent a CT scan of the neck, of which 102 (61.1%) were positive for abscess. The median duration of symptoms in children with and without abscess on CT were the same (48 hours). There was no significant difference in the rate of abscess on CT between children with less than 48 hours of localizing symptoms and 48 or more hours of symptoms at 58.1% and 57.7% respectively (p=0.96). Furthermore, there were no significant difference in gender, C-reactive protein levels, or disease location between children with and without abscess on CT. White blood cell counts were significantly higher in the abscess group (p=0.01), however the median white blood cell count in both groups was above normal.
Conclusions
Because duration of symptoms does not predict finding of abscess on CT scan in pediatric deep neck space infections, it is appropriate to obtain a CT scan upon presentation in all children with symptoms concerning for deep neck space abscess.
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