Document Detail


Indicators of a more complicated clinical course for pediatric patients with retropharyngeal abscess.
MedLine Citation:
PMID:  19963280     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Determine clinical signs or symptoms associated with a more complicated clinical course in patients with retropharyngeal abscesses (RPAs). DESIGN: Retrospective chart review at a tertiary care level Children's hospital. Main Outcome Measures Age, presenting signs and symptoms, laboratory tests, imaging results, antibiotic therapy, surgical approach, pathogens isolated, and duration of hospitalization were evaluated to determine any factors associated with a more complicated clinical course (CCC). RESULTS: Fifteen of one hundred thirty pediatric patients with RPA were identified with a complicated clinical course (CCC). Eight of the fifteen required more than one procedure before the abscess resolved. Patients with multiple abscess sites had a statistically significantly greater chance of requiring multiple procedures to clear the infections (p<0.001). Another seven presented with airway obstruction requiring an admission into the Pediatric Intensive Care (PICU) and/or intubation. All the patients requiring admission to the PICU presented with signs or symptoms of airway obstruction compared to ten of the one hundred fifteen patients (8.7%) with a smooth clinical course (SCC) (p<0.001). Five patients from the CCC group required a bronchoscopy to secure the airway; seven patients required intubation following incision and drainage of the abscess for an average of 5+/-3 days. There was no statistically significant difference between the two groups with respect to pathogens isolated, or antibiotics used. CONCLUSION: Our study suggests that patients with a CCC are more likely to present with airway obstruction or multiple abscess sites than patients with SCC.
Authors:
Abdelaziz M Elsherif; Albert H Park; Stephen C Alder; Marshall E Smith; Harlan R Muntz; F Grimmer
Publication Detail:
Type:  Journal Article     Date:  2009-12-05
Journal Detail:
Title:  International journal of pediatric otorhinolaryngology     Volume:  74     ISSN:  1872-8464     ISO Abbreviation:  Int. J. Pediatr. Otorhinolaryngol.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-04-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003603     Medline TA:  Int J Pediatr Otorhinolaryngol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  198-201     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Division of Otolaryngology/Head and Neck Surgery, University of Utah, 50 North Medical Drive, 3C 120, Salt Lake City, UT 84132, United States.
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MeSH Terms
Descriptor/Qualifier:
Airway Obstruction / diagnosis,  epidemiology
Anti-Bacterial Agents / therapeutic use
Bronchoscopy
Child
Child, Preschool
Clindamycin / therapeutic use
Combined Modality Therapy
Female
Hospitalization / statistics & numerical data
Humans
Infusions, Intravenous
Intensive Care Units, Pediatric / statistics & numerical data
Length of Stay / statistics & numerical data
Male
Mycobacterium Infections / complications,  epidemiology,  rehabilitation
Otorhinolaryngologic Surgical Procedures / methods
Retropharyngeal Abscess / epidemiology,  microbiology*,  rehabilitation
Severity of Illness Index
Streptococcal Infections / complications,  epidemiology,  rehabilitation
Suction
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 18323-44-9/Clindamycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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