Abstract
DEEP NECK SPACE INFECTIONS: COMPARISON OF OUTCOMES BETWEEN DIABETIC AND NON-DIABETIC PATIENTS

Sona Ashokan, KV Rajan, Santhi T.*

ABSTRACT

Aim of the study: The aim of the study was to study the difference in the clinical presentation, microbiological profile, treatment protocol and clinical outcomes of deep neck space infections in diabetics and non diabetics. Materials and Methods: This was a prospective comparative study conducted on 76 patients(diabetics and non diabetics) admitted in the Department of Otorhinolaryngology, TD Medical college, Alappuzha over a period of 18 months from January 1, 2012 to June 30, 2013. Results: The age distribution was from 15 to 75 years. Male to female ratio was 2:1. Fever, pain, neck swelling and odynophagia were the common symptoms. Presence of dyspnoea and chest pain though less common, were the pointers of serious complication. The most common etiology was odontogenic (68.4%) followed by tonsillopharyngeal infection and foreign bodies like fish bone as it was part of the staple diet. No obvious etiological factor was found in 34.2%. The common primary site was submandibular space(64.2%) followed by parapharyngeal space(26.6%). Abscess was present in majority and needed surgical drainage. The most common organism isolated was streptococcus viridans(37.5%). Preponderance of klebsiella species was noted in diabetics. Streptococcus showed susceptibility to pencillin(83.33%), ampicillin(92%), cefotaxime(60.526%). Klebsiella showed susceptibility to gentamicin(42.3%)and ciprofloxacin(28.57%). The complication rate was more in diabetics(34.21%). Contrast enhanced CT was done in cases suspected to have complication. The mean hospital stay was longer in diabetics (19.6days) than non diabetics(6.4days). Conclusion: Deep neck space infection still remains to be life threatening if not heeded promptly. Senescence and diabetes demand surgical intervention and meticulous glycemic control to prevent complications. Judicious use of antimicrobials and timely radiological and surgical interventions have come a long way in the management and providing a cure to this dreaded condition.

Keywords: Neck space infection; Diabetes; Complications; Microbiology; antibiotics.


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