A study on etiology, clinical manifeststions and management of deep neck space infections

Background: Deep neck space infections (DNSI) are serious diseases that involve several spaces in the neck. These are commonly seen in low socioeconomic group with poor oral hygiene, and nutritional disorders. These are bacterial infections originating from the upper aerodigestive tract. The incidence of this disease was relatively high before the advent of antibiotics. Treatment of DNSI includes antibiotic therapy, airway management and surgical intervention. Aims: To determine the various etiological, associated risk factors and clinical manifestations in Deep Neck Space Infections. Materials and methods: It is a Retrospective study done in 80 Patients diagnosed as Deep Neck Space Infection clinically and radiologically and Undergoing treatment for the same Patients diagnosed with Deep Neck Space Infection clinically and radiologically. Results: In this study 50 cases were male and 30 cases were female with a male to female ratio being 1.66 : 1. .The commonest age group was 21— 30 years (32.5%). The commonest site was Ludwigs angina with 19 cases followed by submandibular space infections with 17 cases with swelling has main presenting complaint. In this study 50 cases had dental caries as etiology ; around 18 cases was associated with anaemia. Ultrasound and CECT neck was used as vital imaging techniques. With maximum 25 days and minimum 8 days hospital stay. 61 cases underwent surgical (Incision and Drainage) , 19 cases with medical management. pus culture showed 23 cases with Streptococcus pyogenes followed by 8 cases with Pseudomonas. All cases responded to ceftriaxone and metronidazole combinations with 14 cases with Piperacillin and metronidazole. There were 2 deaths due to impending renal failure. Conclusions: Incision and Drainage is the mainstay of surgical treatment with wide exposure and use of betadine solution impregnated wick at the wound site daily. Patient education regarding oral and dental hygiene has to be stressed and Control of diabetes , proper nutrition to prevent deep neck space infections