CLINICO-MICROBIOLOGICAL PROFILE OF DEEP NECK SPACE INFECTIONS IN A TERTIARY CARE INSTITUTE: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Introduction: Deep Neck Space Infections (DNSI) are potentially life-threatening infections and need vigorous management in patients with or without diabetes mellitus. Worldwide, treatment comprises of early initiation of effective empirical anti-microbial treatment with surgical drainage of abscess. Hence, for optimal management one must know the etiology, presentation, anatomical space involvement as well as common microorganisms encountered in DNSI in both diabetic and non-diabetic patients. Aim: To describe the prevailing clinical and microbiological prole of DNSI in diabetic and non-diabetic patients presenting to a tertiary care hospital in Goa, India. Materials and Methods: This is a prospective, observational, descriptive (hospital based) study conducted in Goa Medical College, Goa over a duration of 18 months. Forty-one cases of DNSI with abscess, consisting of 25 non-diabetic and 16 diabetic patients were included in the study. A comparative evaluation of the clinico-microbiological prole was performed. Results: Pain and swelling in the neck (78%) was the most common presenting symptom in both the groups. Most DNSI were of odontogenic origin (44%) and preceded by upper respiratory tract infections (22%). The peritonsillar space was most frequently involved (27%). The most frequently isolated microorganism in non-diabetic patients belonged to Staphylococcus (29%) and Streptococcus spp, (12.5%) while in diabetic patients they belonged to Klebsiella (35%) and Pseudomonas spp (23.5%). Conclusion: DNSI patients with concomitant diabetes mellitus are likely to present with severe disease, should be monitored closely for development of complications and administered empirical antibiotics providing coverage of Klebsiella and Pseudomonas spp.