Robert Cordesmeyer1, Philipp Kauffmann2, Tröltzsch Markus2, Christian Sömmer3, Helmut Eiffert4, Felix Bremmer5, Rainer Laskawi6. 1. Department of Oral and Maxillofacial Surgery, University of Göttingen, Göttingen, Germany. Electronic address: Robert.cordesmeyer@med.uni-goettingen.de. 2. Department of Oral and Maxillofacial Surgery, University of Göttingen, Göttingen, Germany. 3. Department of Oral and Maxillofacial Surgery, University of Göttingen, Göttingen, Germany; Institute for Medical Microbiology, University of Göttingen, Göttingen, Germany. 4. Institute for Medical Microbiology, University of Göttingen, Göttingen, Germany. 5. Department of Pathology, University of Göttingen, Göttingen, Germany. 6. Department of Otolaryngology-Head and Neck Surgery, University of Göttingen, Göttingen, Germany.
Abstract
OBJECTIVES: Deep neck infections are among the most dangerous acute diseases in the head and neck region. This analysis gives an overview of the bacterial and histopathologic findings of deep neck infections. STUDY DESIGN: From January 2002 to December 2012, 63 patients were diagnosed with and treated for deep neck infections at the University Medical Center Göttingen. Bacterial and histopathologic examinations were made, and the occurrence of bacterial pathogens and histopathologic findings were analyzed. RESULTS: The most commonly isolated aerobic gram-positive pathogen was Streptococcus viridans (26.7%); Staphylococcus epidermidis and Staphylococcus aureus were each found in 16.7% of infections. The most commonly isolated aerobic gram-negative pathogens were Escherichia coli, Klebsiella oxytoca, and Haemophilus influenzae. In 1.6% of patients, a malignant cancer was detected. CONCLUSION: For clear diagnosis and effective therapy, a bacteriologic investigation of deep neck infections is essential because of the heterogeneous spectrum of the detected bacteria. In contrast to Asia, where Klebsiella pneumoniae is the most common pathogen, in South Lower Saxony, Germany, we discovered a dominating spectrum of aerobic gram-positive cocci. Biopsy obtained from an abscess cavity for histologic examination should always be part of the diagnostic process in order to exclude a malignant process.
OBJECTIVES:Deep neck infections are among the most dangerous acute diseases in the head and neck region. This analysis gives an overview of the bacterial and histopathologic findings of deep neck infections. STUDY DESIGN: From January 2002 to December 2012, 63 patients were diagnosed with and treated for deep neck infections at the University Medical Center Göttingen. Bacterial and histopathologic examinations were made, and the occurrence of bacterial pathogens and histopathologic findings were analyzed. RESULTS: The most commonly isolated aerobic gram-positive pathogen was Streptococcus viridans (26.7%); Staphylococcus epidermidis and Staphylococcus aureus were each found in 16.7% of infections. The most commonly isolated aerobic gram-negative pathogens were Escherichia coli, Klebsiella oxytoca, and Haemophilus influenzae. In 1.6% of patients, a malignant cancer was detected. CONCLUSION: For clear diagnosis and effective therapy, a bacteriologic investigation of deep neck infections is essential because of the heterogeneous spectrum of the detected bacteria. In contrast to Asia, where Klebsiella pneumoniae is the most common pathogen, in South Lower Saxony, Germany, we discovered a dominating spectrum of aerobic gram-positive cocci. Biopsy obtained from an abscess cavity for histologic examination should always be part of the diagnostic process in order to exclude a malignant process.