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Nonsurgical management of deep neck infections in children.
Pediatric Infectious Disease Journal 1992 January
Of the 14 pediatric patients with deep neck infections hospitalized at our institution from 1981 through 1990, only 6 were managed surgically. The remaining 8 patients received antibiotic therapy and their infection resolved without the need for surgical drainage. All 8 patients were hospitalized within 4 days (mean, 1.8 days) of onset of illness. Computerized tomography of the neck was performed in 7 and revealed soft tissue swelling and a round or oval cystic lesion in the parapharyngeal region in all 7. Parenteral antibiotic therapy was administered to all patients for 2 to 9 days (mean, 5.5 days) before changing to oral therapy which was continued for 10 to 35 days (mean, 15.1 days). Clinical improvement was evident in all patients 1 to 3 days (mean, 1.6 days) after the onset of antibiotic therapy, with defervescence within 7 days (mean, 3.8 days). Follow-up computerized tomography scans were obtained in 4 patients revealing improvement in 3. It is known that patients with cellulitis of the deep neck tissues may respond well to antibiotic therapy; our experience suggests that some patients with apparent abscess formation as determined by computerized tomography scan may also respond favorably to antibiotic therapy and not require surgical drainage.
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