Presentation, management and outcome of deep neck space infections at University Teaching Hospital of Kigali

Abstract

Background: Deep neck space infection (DNSI) refers to the infection in the potential spaces and fascial planes of the neck with abscess formation or cellulitis. Delayed consultation of these infections can cause life-threatening complications with significant morbidity and mortality.

Objective: The current study aimed at evaluating the clinical presentation, predisposing factors, management and outcome of deep neck space infections at University Teaching Hospital of Kigali.

Materiel and methods: The current research was cross-sectional study, conducted at CHUK/ ENT department. It included patients, who consulted with confirmed DNSIs from September 2017 to February, 2019. The information about sociodemographic characteristics, history, clinical presentation, comorbidities, diagnosis, treatment option, complications, and outcome was recorded using a preestablished data collection tool.

Results: 66 patients were included in the study. 53% of participants were males with a male-to-female ratio of 1.13. The age ranged from 0 to 75 years with the predominant age group of 0-15 years. The history of previous tooth extraction/ infection was found in (33%) and delayed consultation with average of 10.82±7.69 days. The complications represented 21% and were mainly necrotizing fasciitis (66.7%) and airway obstruction (50%). Factors significantly associated with complications included parotid (p=0.008) and para-pharyngeal (p=0.032) involvement and duration of symptoms (p=0.022). The mean hospital stay was 10.23 days and it was significantly associated with the presence of complications (p=0.022). Patients with complete resolution at discharge were 80% while the mortality rate was 5%. Conclusions: DNSIs are common and have significant morbidity and mortality. Early recognition, diagnosis and management may prevent life-threatening complications and poor outcome