Neck Abscess Research Articles

The Role of Neutrophil-to-Lymphocyte Ratio and Mean Platelet Volume in Diagnosing Odontogenic and Non-odontogenic Head and Neck Abscesses

The Role of Neutrophil-to-Lymphocyte Ratio and Mean Platelet Volume in Diagnosing Odontogenic and Non-odontogenic Head and Neck Abscesses

The COVID-19 period influence on pediatric deep neck abscess: Occurrences and clinical presentation

ObjectiveThe purpose of the study was to investigate the influence of the COVID-19 pandemic on the incidence of deep neck infections (DNIs) in pediatric patients. In addition, it describes the clinical, laboratory, and microbiology presentation as well as the clinical outcomes. Study designRetrospective cohort study. SettingsA single tertiary medical center. MethodsAll patients ≤18 years with a diagnosis of DNI, between the years 2010–2022, were included in the study and the yearly incidence of DNI was calculated. Patients were divided according to their diagnosis of retropharyngeal abscesses (RPAs) and parapharyngeal abscesses (PPAs), and according to age; Group 1 (aged 0 to ≤4 years) and Group 2 (aged>4 to ≤18 years). ResultsA total of 46 cases of DNIs; 24 were RPAs and 22 were PPAs, age group 1 had 20 patients, and age group 2 had 26 patients. The overall DNI incidence during 2010 was 0.81 and declined in 2020 (COVID-19 pandemic period) to 0.33, followed by a surge in the incidence of 4.85 in 2022 (post-COVID-19 period).In age group 1 RPAs were more dominant (70 %) while PPAs were dominant (61.5 %) in group 2. (p = 0.034). A higher prevalence of positive cultures was seen in the RPA group compared to the PPA group (75 % vs 33 %, p = 0.025, respectively), and in age group 1 compared to age group 2 (77 % vs 30 %, p = 0.001, respectively). ConclusionIn conclusion, our study provides valuable insights about the disease and vulnerable communities. In addition, we showed a decrease during the COVID-19 pandemic followed by an increase in DNI incidence post-COVID-19 pandemic era. A larger comprehensive prospective study is warranted to gain a deeper understanding of these trends and their underlying causes.

Otomastoiditis Complicated by a Bezold Abscess and Extradural Empyema, Case Report

Bezold's abscess is a rare deep neck abscess and is an intratemporal complication of mastoiditis, the infection erodes through the mastoid cortex to the attachment of the sternocleidomastoid (SCM) muscle. Once the infection has reached this space, it can progress into the infratemporal fossa and trip deep to the investing subcaste of the deep cervical fascia [1]. The spread of infection in this subcaste can lead to a progressive cellulitis/ abscess, but can also do toward the carotid jacket, and thrombosis of the internal jugular tone can do. It was first described by Friedrich Bezold in 1881[5]. Since antibiotics were introduced, the number of reported cases of Bezold's abscesses have significantly dropped. According to some authors, since 1967 there have been less than 100 reported cases in the English literature, only four cases in children under the age of five [1].

Genomic Analysis and Virulence Assessment of Hypervirulent Klebsiella pneumoniae K16-ST660 in Severe Cervical Necrotizing Fasciitis

ObjectiveTo investigate the source of infection in a patient with recurrent severe neck infections caused by Klebsiella pneumoniae and to analyze the virulence of isolates obtained from different sites of the patient. MethodsWe collected preoperative neck abscess puncture fluid, intraoperative neck drainage fluid, sputum, intestinal fecal specimens, and blood samples from a patient who visited Wuxi Second People's Hospital twice between 2017 and 2018. We conducted isolation, identification, drug sensitivity tests, and string tests on the isolates. Capsule serotyping and virulence gene analysis were performed using PCR. The genetic relationship of different isolates was assessed by Multilocus Sequence Typing and virulence was evaluated using the Galleria mellonella infection model. Additionally, whole-genome sequencing was used to analyze the chromosomal and plasmid genes of one isolate. ResultsKlebsiella pneumoniae was detected in the sputum and fecal specimens from both hospitalizations, as well as the preoperative ultrasound-guided puncture fluid and intraoperative drainage fluid from the first hospitalization, resulting in six isolates. These isolates were all K16 serotype, positive in the string test, and identified as ST660 by Multilocus Sequence Typing, indicating they belonged to the same clone. Virulence gene analysis showed that wcaG, iucB, iroNB, rmpA, rmpA2, Aer, kfuBC, ureA, fimH, mrkD, uge, and peg344 were positive, while allS, cf29a, and Wzy_K1 were negative. In the Galleria mellonella virulence assay, the lethality of different isolates was dose-dependent. The K16 group showed significantly higher larval mortality compared to other control groups (including K1, K2, K5, K20, and K57 groups). Genome sequencing revealed that plasmid p17388 carried numerous virulence genes and insertion sequences, particularly ISKPN74, and showed high homology with other Klebsiella plasmids. ConclusionThis study is the first to report severe cervical necrotizing fasciitis caused by the K16-ST660 Klebsiella pneumoniae Isolate. The high virulence of these isolates was confirmed by the Galleria mellonella virulence assay and the detection of numerous virulence genes. In-depth analysis of plasmid p17388 suggests that ISKPN74 may enhance stable integration of the plasmid into the bacterial chromosome through recombinases and transposases, thereby reducing the likelihood of plasmid loss and increasing bacterial virulence. Additionally, IS5 family insertion sequences may carry extra promoters or enhancers that, when inserted upstream of mucoviscosity-associated genes such as rmpA, may increase the transcription levels of downstream genes. This ISKPN74-mediated integration or insertion reveals a complex genetic mechanism that may contribute to the severity of infections caused by ST660 isolates. Our findings offer new insights into the virulence and structure of ST660-K16 Klebsiella pneumoniae, suggesting that further investigation into the specific mechanisms by which these insertion sequences enhance virulence could aid in developing novel infection management strategies.

Lemierre’s syndrome associated-diabetic ketoacidosis in an elderly female: a case report

BackgroundThe co-occurrence of Lemierre’s syndrome, primarily triggered by Fusobacterium necrophorum following oropharyngeal infection, with diabetic ketoacidosis (DKA) in diabetes mellitus (DM) patients, underscores a rare but life-threatening clinical scenario. Lemierre’s syndrome induced DKA is extremely rare, with only one case report in adult and no case yet reported in elderly.Case PresentationWe reported a case of a 69-year-old female who presented with DKA triggered by deep neck space infection (DNSI), leading to rapid clinical deterioration within 6 h that necessitated high flow nasal cannula (HFNC) and antibiotic administration. Laboratory findings included leukocytosis, elevated serum C-reactive protein, hyperglycemia, ketonemia, and severe metabolic acidosis. Culture of the fluid from a neck mass puncture drainage and blood were positive for Klebsiella pneumoniae. The patient was further complicated by thrombosis of the left internal jugular vein with extension to the sigmoid and a neck abscess surrounding the carotid artery sheath, consistent with Lemierre’s syndrome. This condition was managed aggressively with fluid resuscitation, insulin therapy, surgical drainage, antibiotics, and anticoagulation led to a significant improvement in her condition. Following a 13-day hospitalization, there was significant clinical improvement, culminating in the patient’s discharge.ConclusionsThe case highlights the need for greater awareness and understanding of the interrelated and mutually promoting conditions of DKA and Lemierre’s syndrome among clinicians. Early recognition and treatment are crucial to prevent mortality in such complex cases.

A Case of Necrotizing Lymphadenitis Misdiagnosed as a Neck Abscess.

Histiocytic necrotizing lymphadenitis (HNL), also known as Kikuchi disease, is a relatively rare sub-acute necrotic localized lymphadenitis. This benign, self-limiting condition is characterized by fever, painful lymphadenopathy, skin rash, and other systemic symptoms. Due to its nonspecific presentation, unclear etiology, and pathogenesis, HNL has a low incidence rate in clinical practice. Insufficient awareness among clinicians and pathologists can easily lead to misdiagnosis. This article reported a 27-year-old female patient who was admitted to the hospital with fever, neck pain, and enlarged lymph nodes in the neck. There were no special medical or personal histories, and postoperative pathology confirmed tissue necrotizing lymphadenitis. After treatment with steroids and symptomatic therapy, she recovered and was discharged from the hospital. Follow-up to date has shown no recurrence.

Predictors of Emergency Interventions in Acute Airway Obstructive Diseases: A Retrospective Single-Center Observational Study.

The factors related to emergency intervention for internal medicine conditions leading to airway obstruction are not clear. We aimed to identify factors associated with emergency interventions in acute airway obstructive diseases (AAODs). This is a retrospective observational single-center study. We defined AAODs as acute epiglottitis, peritonsillar abscess, tonsillitis, pharyngitis, oral floor abscess, neck abscess, angioedema, Lemierre's syndrome, hemoptysis, and airway foreign body. We compared the group required airway interventions (intubation, cricothyroidotomy, tracheostomy) with the group treated conservatively admitted to Yokosuka Kyosai Hospital, Japan (tertiary referral hospital) for AAOD between April 2012 and March 2022. Two hundred fifty-five patients were admitted for AAOD, 104 patients were excluded, and 150 patients (39 intervention group, 111 conservative group) were analyzed. Univariate analysis revealed significant age differences (74(61-78) vs 67(31-76), p<0.01), Glasgow Coma Scale (15(14-15) vs 15(15-15), p<0.01), respiratory rate (24(20-30) vs 20(16-22), p<0.01), National Early Warning Score (NEWS) (6(3-9) vs 3(1-5), p<0.01), Sequential Organ Failure Assessment (SOFA) score (2(1-4) vs 0(0-2), p<0.01), stridor (26% vs 2%, p<0.01), dysphagia (41% vs 21%, p=0.02), drooling (18% vs 3%, p<0.01), frequent suctions (6% vs 0%, p<0.01), airway examination abnormalities (AEAs) (69% vs 32%, p<0.01) and diagnosis (p<0.01). Multivariate logistic regression analysis indicated AEA (OR=9.41, 95%CI 3.66-24.2), upper airway diseases (OR=5.74, 95%CI 2.12-15.6), and SOFA score (OR=2.88, 95%CI 1.06-7.83) were predictors for intervention. However, the sensitivity and specificity of AEA were 0.69 (95%CI 0.52-0.83) and 0.69 (95%CI 0.59-0.77), respectively. AEAs were associated with a high risk of airway interventions in AAOD. Nevertheless, the sensitivity and specificity were insufficient.

The Radiographic Characteristics of Mandibular Wisdom Teeth That Can Cause Severe Deep Neck Infection.

Mandibular wisdom teeth can occasionally cause infections, which can progress to severe deep neck infections (DNIs) including deep neck abscesses or necrotizing soft tissue infections, which are fatal. This study aimed to identify the radiographic characteristics of mandibular wisdom teeth that developed severe DNIs. This study included patients who were admitted for the treatment of severe mandibular wisdom tooth infection between July 2012 and June 2024 at a single center. Patient characteristics, clinical data, and radiographic findings were analyzed and compared between the severe DNI group and mild DNI group including patients with cellulitis or superficial abscess. P < 0.05 was considered significant. Nineteen of 42 patients (45.2%) were included in the severe DNI group. The multivariate analysis showed that the highest odds ratio (OR) was for the presence of a radicular cyst (OR=17.7), followed by the presence of a dentigerous cyst (OR =14.5). The most common mandibular wisdom tooth with a dentigerous cyst in patients with severe DNIs was inverted according to Winter's classification and type IIIC in the Pell and Gregory classification. Radiographic characteristics associated with severe DNIs included the presence of radicular and dentigerous cysts in the mandibular wisdom teeth. Especially in dentigerous cysts, deeply impacted teeth should be taken attention.

Management of a Piriform Sinus Fistula With Chronic Neck Infection in an Adult.

A pyriform sinus fistula (PSF) is a rare congenital anomaly due to failed obliteration of the third or fourth pharyngeal pouch. Diagnosis and management of PSF remains controversial. We present a case of PSF and discuss its diagnosis and management. Case report and literature review. A 26-year-old female with a chronic left lateral neck abscess was diagnosed with a left PSF. She underwent surgery through a combined approach to close the openings of the PSF, internally and externally. We first placed a blunted ET tube into the internal opening of the PSF. We then performed an external transcervical approach to close the PSF at the cricothyroid membrane. Briefly, after a neck debridement and washout of the chronic neck infection, we identified the recurrent laryngeal nerve (RLN) in Lore's triangle. We performed left hemithyroidectomy to facilitate the dissection and protection of the RLN to its entrance into the larynx. A flexible laryngoscope was then inserted into the left piriform sinus through the ET tube to guide external dissection by transillumination. The scar tissue attached to the superior pole of the left thyroid lobe was then ligated and divided along the cricothyroid membrane. Lastly, we cauterized the internal opening of the PSF. The patient has remained recurrence-free for 1.5 years with normal vocal cord mobility. Histopathology revealed presence of a squamous-lined tract adjacent to the thyroid tissue. Surgical treatment for patients with PSF should be aimed at closing the internal and external openings of the PSF, debriding chronic neck infection, and protecting the laryngeal nerves, instead of removing the entire tract. A concurrent hemithyroidectomy facilitates the identification and protection of the RLN, as well as excision of the tract. Differentiation between third and fourth branchial cleft fistulae may not be clinically necessary, as it is unlikely to alter the therapeutic plan.

A multicentre observational study of paediatric head and neck abscesses

IntroductionIn winter of 2022/3 paediatric ENT surgeons across the UK observed that the incidence of severe abscesses in the head and neck and associated complications was higher than seen in previous years. We aimed to collate and evaluate data from across the UK to establish if this was a true rise in cases, and to describe the factors associated. MethodsA multicentre retrospective data collection was undertaken from 13 units across the UK. Patients admitted between September 2022–February 2023 with a head and neck abscess including sinogenic, otogenic, deep and superficial neck abscesses were included. Demographic, disease specific, management and outcome data were collected. Hospital episode statistic data were also requested and analysed to allow for comparison with previous 10 years of head and neck abscesses. Results262 patients with abscesses of the head and neck were admitted during the study period, 100 between September and November and 163 between December and February. Mastoid abscesses were the most common abscess across both groups. The rate of group A streptococcus + culture results rose significantly from 12 % in autumn group to 30 % in winter (p = 0.02). The rate of intracranial complications rose from 10 % to 18 % (p = 0.11) and the rate of venous thrombosis rose over the same timeframe from 3 % to 14 % (p = 0.01). DiscussionThis study demonstrated a statistically significant rise in the rate of group A streptococcus associated abscesses when comparing Autumn and Winter 2022/2023. Over the same timeframe a statistically significant rise in the proportion of patients with venous thromboses associated with H&N abscesses was noted. Interestingly, despite perceived national consensus regarding a spike in abscess incidence, the number of abscesses seen in winter 2022/2023 was in keeping with expected rates of paediatric H&N abscesses, based on pre covid year-on-year rise in incidence.

Recurrent neck Abscess by Migrating Fishbone Penetrating Thyroid Found in Subcutaneous Tissue: Case Report

Recurrent neck Abscess by Migrating Fishbone Penetrating Thyroid Found in Subcutaneous Tissue: Case Report

Impact of Bacterial Etiology on Procalcitonin, C-reactive Protein and Hematological Parameters: Evaluating Mean Platelet Volume for Differentiating Gram-Negative and Gram-Positive Bacteria in Odontogenic Versus Non-odontogenic Head and Neck Abscesses.

Introduction Head and neck abscesses, which can originate from odontogenic or non-odontogenic sources, pose significant diagnostic challenges due to their diverse bacterial etiologies. This study aims to investigate the impact of bacterial etiology on procalcitonin (PCT), C-reactive protein (CRP), and various hematological parameters, and to assess the diagnostic performance of mean platelet volume (MPV) in differentiating between Gram-negativebacteria (GNB) and Gram-positive bacteria (GPB) in adults with odontogenic and non-odontogenic head and neck abscesses. Materials and methods Our retrospective analysis of a prospective study comprised 80 patients: 50 individuals (56% men, average age 41.6±18.18 years) with odontogenic and 30 patients (66.7% men, average age 44.53±15.49 years) with non-odontogenic head and neck abscesses during the period from July 2021 to June 2022. White blood cell count (WBC); neutrophil (Neu) and lymphocyte (Ly) count; MPV, and platelet count (PLT) were derived from the results of complete blood count. MPV/PLT (MPI) was calculated by dividing MPV by PLT. CRP levels (mg/l) were quantified via immunoturbidimetric analysis utilizing latex-enhanced particlesand PCT levels (ng/ml) by latex-enhanced immunoturbidimetric assay. Results In 25 (31.3%) of all 80 patients, no microorganisms were isolated (sterile cultures); in 28 (35%) resident microflora were isolated; in seven (8.8%) GNB were isolated; and in 17 (21.3%) GPB were isolated. CRP and Neu were significantly higher in patients with odontogenic abscesses compared to non-odontogenic ones. PLT and PCT were lower in patients with odontogenic abscesses vs those with non-odontogenic abscesses. Additionally, according to bacterial type, MPV, MPI and PCT were significantly higher in GPB compared to GNB. WBC, Neu and PLT were higher in patients with GNB vs GPB. Significant correlations were found between MPV andLy, and between MPV and Neu, regardless of the abscess origin or etiological factor. MPI exhibited an area under the curve of the receiver operating characteristic (AUC-ROC)=0.776, MPV of 0.541, and PCT of 0.568in distinguishing patients with GPB from GNB. A cut-off value of 0.029 was derived for MPI (70.6% sensitivity and 80% specificity). Conclusions This study highlights the impact of bacterial etiology on inflammatory and hematological markers in head and neck abscesses. Odontogenic abscesses showed higher CRP and Neu, indicating a stronger inflammatory response, while non-odontogenic abscesses had higher PLT, Ly, and PCT. MPI proved to be a more effective diagnostic marker (cut-off value of 0.029) than MPV or PCT for distinguishing between GPB and GNB, suggesting its valuable role in clinical practice for accurate and timely diagnosis.

Bezold Abscess in a Case of Eosinophilic Otitis Media.

A 57-year-old man with a history of bronchial asthma and eosinophilic sinusitis presented to the emergency department with an exacerbation of otitis media. His primary complaints were otopyorrhea, headache, and neck pain with redness. Contrast-enhanced computed tomography revealed a posterior neck abscess contiguous with the mastoid process. The patient underwent mastoidectomy and received antimicrobial therapy. Eosinophilic granulation tissue in the middle ear obstructed the middle ear aditus and directed the inflammatory process toward the mastoid tip. Bezold abscess is a rare extracranial complication of acute mastoiditis. Therefore, clinicians should consider neck pain with redness as an important physical sign that suggests Bezold abscess in patients with otitis media.

Endoscopic diagnostic and therapeutic management of branchial cleft fistula type III & IV: a single tertiary centre experience.

To date, recurrent neck abscesses associated with branchial anomalies are treated using a variety of techniques. Management strategies may include various imaging modalities and surgical methods. Endoscopic assessment and electrocauterization are the preferred diagnostic modalities and treatment strategies that have recently gained widespread acceptance and popularity. This was a retrospective review on patients' medical record from 2016 to 2023. Seven patients underwent endoscopic cauterization at our centre, a tertiary academic institution. Five of the patients (71.5%) achieved complete remission. Two patients experienced recurrence within 6 months that necessitated re-cauterization once but subsequently recovered completely. Currently, endoscopic management is the preferred approach compared to the typical open neck excision surgery as it is significantly less invasive, resulting in lesser morbidity and similar success rates. At presentation, all of them had ultrasound neck that suggestive of neck abscess. Computed tomography or magnetic resonance imaging unable to provide adequate information about the side of internal opening of fistula where only 3 out of 7 patients demonstrated tract up to the ipsilateral region of pyriform fossa. Management outcomes of this limited case series showed the potential benefits of endoscopic cauterization as the minimally invasive therapeutic method for recurrent neck abscesses caused by third and fourth branchial cleft fistulas but also to suggest the possibility as the first diagnostic tool prior to imaging studies.

Recurrent Unexplained Neck Abscess Due to 4th Branchial Anomaly

Recurrent Unexplained Neck Abscess Due to 4th Branchial Anomaly

Deep-learning denoising minimizes radiation exposure in neck CT beyond the limits of conventional reconstruction

BackgroundNeck computed tomography (NCT) is essential for diagnosing suspected neck tumors and abscesses, but radiation exposure can be an issue. In conventional reconstruction techniques, limiting radiation dose comes at the cost of diminished diagnostic accuracy. Therefore, this study aimed to evaluate the effects of an AI-based denoising post-processing software solution in low-dose neck computer tomography. Materials and MethodsFrom 01 September 2023 to 01 December 2023, we retrospectively included patients with clinically suspected neck tumors from the same single-source scanner. The scans were reconstructed using Advanced Modeled Iterative Reconstruction (Original) at 100% and simulated 50% and 25% radiation doses. Each dataset was post-processed using a novel denoising software solution (Denoising). Three radiologists with varying experience levels subjectively rated image quality, diagnostic confidence, sharpness, and contrast for all pairwise combinations of radiation dose and reconstruction mode in a randomized, blinded forced-choice setup. Objective image quality was assessed using ROI measurements of mean CT numbers, noise, and a contrast-to-noise ratio (CNR). An adequately corrected mixed-effects analysis was used to compare objective and subjective image quality. ResultsAt each radiation dose level, pairwise comparisons showed significantly lower image noise and higher CNR for Denoising than for Original (p < 0.001). In subjective analysis, image quality, diagnostic confidence, sharpness, and contrast were significantly higher for Denoising than for Original at 100 and 50 % (p < 0.001). However, there were no significant differences in the subjective ratings between Original 100 % and Denoising 25 % (p = 0.906). ConclusionsThe investigated denoising algorithm enables diagnostic-quality neck CT images with radiation doses reduced to 25% of conventional levels, significantly minimizing patient exposure.

Mortality Audit in the Head and Neck Surgery Ward: A Retrospective Study in a Tertiary Care Hospital of Pakistan.

Background Mortality audit is important for healthcare workers, but this data is lacking in developing countries. It helps to providematerial about the cause of death, mortality rate, age, and gender. In a surgical department, such information can help identify key public health challenges that are contributing to morbidity and mortality, and this information can helphealthcare workers better tackle those pathologies and focus on their prevention and treatment. Materials and methods A retrospective study was conducted at the Department of ENT - Head and Neck Surgery, Pakistan Institute of Medical SciencesHospital, Islamabad. Five-year data was collected from the mortality register of the ward from January 2019 to December 2023, including the age, gender, surgical diagnosis, course of hospital stay, and cause of death. The collected data was statistically analyzed and presented in the form of tables and figures. Results A total of 53 deaths in 3890 admissions were found on record, with an overall mortality rate of 1.4%. The median age of participants was 61.5 years, with a preponderance of the male gender (n=34; 64.2%). The most common cause of death was head and neck malignancy (n=39; 73.6%), followed by head and neck abscesses (n=9; 17%). The least common cause of death was diphtheria (n=2; 3.8%). Conclusion Death was more common in old-age patients, with more prevalence in the male population. The most common cause of mortality was head and neck malignancy. The total death count almost remained constant through the years.

Abscess Lodged Within the Sternocleidomastoid Muscle Secondary to Septic Arthritis

In deep neck space infections, structures within the fascial compartments may become compromised, leading to neurovascular, bony, or airway issues. Most commonly, infections of the oral cavity, face, or superficial neck spread through the lymphatics into the deeper tissues, causing lymphadenopathy and suppurative fluid collection leading to abscess formation. While some neck abscesses occur idiopathically, a retrospective review found that dental infection was the most common etiology (43%), followed by intravenous (IV) drug use (12%) and tonsillitis (6%). In contrast, our patient denied IV drug usage and had no significant medical or dental history that could account for her symptoms. Instead, she developed her neck abscess secondary to septic arthritis of the knee. Although synchronous localized infection of multiple sites is possible, cultures taken from the knee and the neck were both sensitive to Methicillin Resistant Staphylococcus Aureus (MRSA), indicating that the abscess likely formed secondary to septic arthritis. Furthermore, the patient’s history of diabetes likely contributed to the progression of the infection. Rarely does a knee infection travel hematogenously and seed within the neck. Moreover, the abscess was lodged within the middle of the sternocleidomastoid muscle rather than within the fascial compartments. Physicians in the future should be aware of this distinct presentation of deep neck space abscesses.

Association of the Moore sign with the presence of deep neck abscess of retropharyngeal space

Association of the Moore sign with the presence of deep neck abscess of retropharyngeal space

The Impact of COVID-19 Restrictions on Hospital Admissions of Common Head and Neck Infections.

Following the emergence of COVID-19, multiple preventative measures were implemented to limit the spread of the disease. This study aims to elucidate the impact of COVID-19 restrictions on hospital admissions of otolaryngology-related infections. A retrospective chart review was conducted to capture all admissions for otolaryngology-related infections in the 2 years pre- and post-COVID-19 at the Health Sciences Centre in Winnipeg, Manitoba. These infections included croup, tracheitis, neck abscess, peritonsillar abscess, otitis media, mastoiditis, sinus infection, orbital infection, pharyngotonsillitis, retro/parapharyngeal abscess, and acute epiglottitis. Demographic information and admission details were collected and analyzed to compare pre- and post-COVID-19 admissions. Further analysis was conducted to compare hospital admissions of patients from rural/remote regions. Between March 2018 and March 2022, 253 pediatric patients and 197 adults were admitted for otolaryngology-related infections. Total pediatric admissions decreased post-COVID-19 (154 pre-COVID-19, 99 post-COVID-19; p < 0.001) whereas adult admissions remained stable (107 pre-COVID-19, 90 post-COVID-19; p = 0.25). No significant difference in mean patient age, admission duration, surgical rates or in the proportion of admissions from patients from rural/remote regions was observed in the pediatric or adult cohort when comparing pre-COVID-19 data to post-COVID-19 data. Diagnosis-specific changes in admissions were observed in pediatric croup (40 pre-COVID-19, 15 post-COVID-19; p < 0.001) and in adult orbital infections (30 pre-COVID-19, six post-COVID-19; p < 0.001). Following the implementation of COVID-19 restrictions, there was a decrease in admissions due to pediatric croup and adult orbital infections with an overall decrease in pediatric Otolaryngology-infection related admissions. 3 Laryngoscope, 134:3542-3547, 2024.