Abstract
Deep neck infection (DNI) is a serious disease of deep neck spaces that can lead to morbidities and mortality. Acute epiglottitis (AE) is a severe infection of the epiglottis, which can lead to airway obstruction. However, there have been no studies of risk factors in patients with concurrent DNI and AE. This study was performed to investigate this issue. A total of 502 subjects with DNI were enrolled in the study between June 2016 and August 2021. Among these patients, 30 had concurrent DNI and AE. The relevant clinical variables were assessed. In a univariate analysis, involvement of the parapharyngeal space (OR = 21.50, 95% CI: 2.905–158.7, p < 0.001) and involvement of the submandibular space (OR = 2.064, 95% CI: 0.961–4.434, p < 0.001) were significant risk factors for concurrent DNI and AE. In a multivariate analysis, involvement of the parapharyngeal space (OR = 23.69, 95% CI: 3.187–175.4, p = 0.002) and involvement of the submandibular space (OR = 2.465, 95% CI: 1.131–5.375, p < 0.023) were independent risk factors for patients with concurrent DNI and AE. There were no differences in pathogens, therapeutic managements (tracheostomy, intubation, surgical drainage), or hospital staying period between the 30 patients with concurrent DNI and AE and the 472 patients with DNI alone (all p > 0.05). However, we believe it is significant that DNI and AE are concurrent because both DNI and AE potentially cause airway obstruction, and concurrence of these two diseases make airway protection more difficult. The infections in critical spaces may cause the coincidence of these two diseases. Involvement of the parapharyngeal space and involvement of the submandibular space were independent risk factors associated with concurrent DNI and AE. There were no differences in pathogens between the concurrent DNI and AE group and the DNI alone group.
Highlights
Deep neck infection (DNI) is a lethal bacterial infection in the potential spaces of the neck [1]
To investigate the risk factors associated with concurrent DNI and Acute epiglottitis (AE), we collected data on the patients’ gender, age, hospital stay, C-reactive protein (CRP) level, blood
To investigate the risk factors associated with concurrent DNI and AE, we collected data on the patients’ gender, age, hospital stay, C-reactive protein (CRP) level, blood sugar sulegvaerl,ledviaelb,edteiasbmeteelslimtuesl(liDtuMs)(DstMatu) s,tapteursf,oprmerafonrcme aonf cinecoisfiionnciasniodndarnadindagraeinsuagrgeesruyr,gneurmy, nbuemr boefrspofacsepsaacfefsecatfefedcbteydDbNyID, dNeIe,pdneepcknsepcakcsepinacveolivnevmolevnetm(Feingtu(rFeig2u),rper2e)s,epnrceeseonf cmeeodfimaesdtiinaisttiisn,ittrias,chtreaocshteoomstyo,many,dasnpdecsipeescoiefspoafthpoagtheongseinsvoinlvveodlv. ed
Summary
Deep neck infection (DNI) is a lethal bacterial infection in the potential spaces of the neck [1]. Acute epiglottitis (AE) is a bacterial infection of supraglottic structures that results in a symptom complex consisting of a sore throat, stridor, odynophagia, muffled voice, and a high fever; it is a potentially life-threatening condition secondary to airway obstruction [7]. DNI is clinically first suspected in patients with shortness of breath, local heat, redness, and swelling in the neck. The otolaryngologist will use a flexible fiberoptic a high fever; it is a potentially life-threatening condition secondary to airway obstruction [7]. DNI is clinically first suspected in patients with shortness of breath, local heat,2roefd10ness, and swelling in the neck. The otolaryngologist will use a flexible fiberoptic laryngoscope to look for an upper airway obstruction, and the coexistence of AE may be AlfdsfAdcgaooeaaiiEErususpuryeednnts[[naai8e8didPPcssgn,,e..9rer9ssogeess]e]hs.vv.pircoisTiiTitsocosoichhpkkcuucoeeeossmsfarramhtnaasspocoppttdptuulcoeleilodkcdcuuiracoosiitteaatemikiefcscnstodefodsmsmrod.rhhr.tAbcaaoohoaiAnnEwwdenmaaEineecggtuodoydeeenrp.commbettepHchhicseceedeasaonunriisttwtttrtsayassriiiietooet.nrneavnmwmHstpepceapeoereasa,yrwttppootipihoeeaaeftrnebnevttotiicrhtsteeetstestereninro,cswwhutttnestsaichiiotvtttmmoehhiwnfeoraaettontboyyhhh,efhdeeeppaeatiancnrcrshvieeooedreenssaooweetosbacchnnaeccieperysttuuew,.rwwcrnraeTroranveiiehneyttndinhhxio,osccisuacescepsentoostvreooundnesneffdcvctrcuttsuueiyehheodrrDeevuowrrisseeeeNfseeannrsAessIttttrtwwcEetDuDDahgdoomnNNeNairlrlecaIIIeeedasyftatacuiohhnrnnabsraeaddngeee-ll rpiesrkfofarcmtoerds tfoorinthveesctoigoaccteurtrheenrcieskoffathcteosrestiwnopdatisieenastsesw. A total of 502 patients with DNI were enrolled in the study, among whom 30 patients had cooccurrence of DNI and AE at the time of diagnosis
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