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Journals / Osmangazi Tıp Dergisi / 2026 / Cilt: 48 Sayı: 3

Deep Neck Infections in Children: Clinical Presentation and Determinants of Treatment Decisions

Çocuklarda Derin Boyun Enfeksiyonları: Klinik Bulgular ve Tedavi Kararını Belirleyen Faktörler

Nagihan Gülhan Yaşar(Ankara Bilkent Şehir Hastanesi)0000-0003-1207-3584
Çetin Şahutoğlu(Ankara Bilkent Şehir Hastanesi)0009-0002-0870-331X
Abdullah Konur Alp Kara(Ankara Bilkent Şehir Hastanesi)0009-0002-8947-4570
Ağah Yeniçeri(Ankara Bilkent Şehir Hastanesi)0000-0002-5024-4009
Burak Hazır(Ankara Bilkent Şehir Hastanesi)0000-0002-2338-0806
Ayşe Seçil Kayalı Dinç(Ankara Bilkent Şehir Hastanesi)0000-0001-9004-8806
Pages
477–484
Publication Date
2026-05-12
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In conclusion, abscess size remains the most reliable factor guiding surgical decision-making in pediatric deep neck infections.

📌 3 Key Takeaways

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Objective & Hypothesis:Pediatric deep neck infections (DNIs) are clinically significant conditions due to their potential for rapid progression and serious complications.
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Key Findings & Data:This retrospective study included 99 pediatric patients aged 1–17 years who were hospitalized with deep neck infections between 2021 and 2025.
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Conclusion & Impact:In conclusion, abscess size remains the most reliable factor guiding surgical decision-making in pediatric deep neck infections.
🔬Design:Review & Systematic Survey
📍Scope:2021 Verileri
⚙️Variables:Derin boyun enfeksiyonu · abse · inflamatuar indeks

Abstract

Pediatric deep neck infections (DNIs) are clinically significant conditions due to their potential for rapid progression and serious complications. This study aimed to evaluate the clinical, radiological, and microbiological characteristics of pediatric DNIs and to investigate the association between the C-reactive protein–albumin–lymphocyte (CALLY) index and the need for surgical drainage and clinical outcomes. This retrospective study included 99 pediatric patients aged 1–17 years who were hospitalized with deep neck infections between 2021 and 2025. Demographic data, clinical presentation, imaging findings, laboratory parameters, microbiological results, antibiotic therapy, and surgical interventions were reviewed. The CALLY index, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were calculated using blood samples obtained at hospital admission. The mean age was 7.9 ± 4.7 years, and surgical drainage was performed in 59.6% of patients. Abscess dimensions were significantly larger in the drainage group (p 0.05). Among culture-positive cases, Streptococcus species and Staphylococcus aureus were the most frequently isolated pathogens. In conclusion, abscess size remains the most reliable factor guiding surgical decision-making in pediatric deep neck infections. Inflammation-based indices, including the CALLY index, showed limited value in predicting surgical drainage or clinical prognosis.

Özet

Pediatrik derin boyun enfeksiyonları (DBE), hızlı ilerleyebilmesi ve ciddi komplikasyonlara yol açabilmesi nedeniyle klinik açıdan önemlidir. Bu çalışmada, pediatrik DBE’lerin klinik, radyolojik ve mikrobiyolojik özelliklerini değerlendirmek ve C-reaktif protein–albumin–lenfosit (CALLY) indeksinin cerrahi drenaj gereksinimi ve klinik prognoz ile ilişkisini araştırmak amaçlandı. 2021–2025 tarihleri arasında derin boyun enfeksiyonu tanısıyla yatırılarak tedavi edilen 1–17 yaş arası 99 pediatrik hasta retrospektif olarak incelendi. Demografik veriler, klinik bulgular, görüntüleme sonuçları, laboratuvar parametreleri, mikrobiyolojik kültürler, antibiyotik tedavileri ve cerrahi girişimler kaydedildi. CALLY indeksi, nötrofil-lenfosit oranı (NLR) ve trombosit-lenfosit oranı (PLR) hastaneye yatışta alınan ilk kan örneklerinden hesaplandı. Hastaların ortalama yaşı 7,9 ± 4,7 yıl olup %59,6’sına cerrahi drenaj uygulandı. Drenaj yapılan grupta apse boyutları anlamlı olarak daha büyüktü (p 0,05). Kültür pozitif hastalarda en sık izole edilen patojenler Streptococcus türleri ve Staphylococcus aureus idi. Sonuç olarak, pediatrik derin boyun enfeksiyonlarında cerrahi karar sürecinde apse boyutu en güvenilir belirleyici olmaya devam etmektedir. CALLY indeksi ve diğer inflamasyona dayalı indekslerin cerrahi drenaj gereksinimi ve prognozu öngörmedeki katkısı sınırlıdır.

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Cite This Article

Yaşar, N. G., Şahutoğlu, Ç., Kara, A. K. A., Yeniçeri, A., Hazır, B., Dinç, A. S. K. (2026). Deep Neck Infections in Children: Clinical Presentation and Determinants of Treatment Decisions. Osmangazi Tıp Dergisi, Cilt: 48 Sayı: 3, 477–484. https://doi.org/10.20515/otd.1872715

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References (21)

  1. Eftekharian A, Roozbahany NA, Vaezeafshar R, Narimani N. Deep neck infections: a retrospective review of 112 cases. European Archives of Oto-Rhino-Laryngology. 2009;266(2):273-7.
  2. Novis SJ, Pritchett CV, Thorne MC, Sun GH. Pediatric deep space neck infections in US children, 2000–2009. International journal of pediatric otorhinolaryngology. 2014;78(5):832-6.
  3. Kim J-M, Hoang H, Choi J-S. Dynamics of Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR), and Platelet-to-Lymphocyte Ratio (PLR) in Patients with Deep Neck Infection. Journal of Clinical Medicine. 2024;13(20):6105.
  4. Treviño-Gonzalez JL, Acuña-Valdez F, Santos-Santillana KM. Prognostic value of systemic immune-inflammation index and serological biomarkers for deep neck infections. Medicina Oral, Patología Oral y Cirugía Bucal. 2023;29(1):e128.
  5. Xu Z, Chen C, Zhao J, Li C, Zang B, Xiong X. The CALLY Index as a Predictive Tool for Postoperative Pneumonia in Esophageal Squamous Cell Carcinoma: A Retrospective Cohort Study. Journal of Inflammation Research. 2025:5463-75.
  6. Chen D, Bin M, Kang L, Chen L, Hu H. Prognostic evaluation of ischemic stroke complicated by pulmonary infection using SII and CALLY indices. American Journal of Translational Research. 2025;17(9):6767.
  7. Wen Y, Zhang Y, Tang Y, Chen Y. Protective role of the C-reactive protein-albumin-lymphocyte (CALLY) index for cardiovascular risk and mortality. Scientific Reports. 2025;15(1):44946.
  8. Brook I. Microbiology and antimicrobial management of head and neck infections in children. Advances in pediatrics. 2008;55(1):305-25.
  9. Huang C-M, Huang F-L, Chien Y-L, Chen P-Y. Deep neck infections in children. Journal of microbiology, immunology and infection. 2017;50(5):627-33.
  10. Chang L, Chi H, Chiu N-C, Huang F-Y, Lee K-S. Deep neck infections in different age groups of children. Journal of Microbiology, Immunology and Infection. 2010;43(1):47-52.
  11. Nagy M, Backstrom J. Comparison of the sensitivity of lateral neck radiographs and computed tomography scanning in pediatric deep‐neck infections. The Laryngoscope. 1999;109(5):775-9.
  12. Vural C, Gungor A, Comerci S. Accuracy of computerized tomography in deep neck infections in the pediatric population. American journal of otolaryngology. 2003;24(3):143-8.
  13. Meyer AC, Kimbrough TG, Finkelstein M, Sidman JD. Symptom duration and CT findings in pediatric deep neck infection. Otolaryngology—Head and Neck Surgery. 2009;140(2):183-6.
  14. Carbone PN, Capra GG, Brigger MT. Antibiotic therapy for pediatric deep neck abscesses: a systematic review. International journal of pediatric otorhinolaryngology. 2012;76(11):1647-53.
  15. Shimizu Y, Hidaka H, Ozawa D, Kakuta R, Nomura K, Yano H, et al. Clinical and bacteriological differences of deep neck infection in pediatric and adult patients: review of 123 cases. International Journal of Pediatric Otorhinolaryngology. 2017;99:95-9.
  16. Wong DK, Brown C, Mills N, Spielmann P, Neeff M. To drain or not to drain–Management of pediatric deep neck abscesses: A case–control study. International journal of pediatric otorhinolaryngology. 2012;76(12):1810-3.
  17. Demongeot N, Akkari M, Blanchet C, Godreuil S, Prodhomme O, Leboucq N, et al. Pediatric deep neck infections: Clinical description and analysis of therapeutic management. Archives de Pédiatrie. 2022;29(2):128-32.
  18. Fan D, Hou J, Yang J, Zhao Z, Fang Q, Wu X. Predictive value of serum interleukin-6 to determine surgical drainage of deep neck space infection in adults. European Archives of Oto-Rhino-Laryngology. 2023;280(3):1403-10.
  19. Qi L, Chen Q, Li Y, Guo Y. Association between the C-reactive protein–albumin–lymphocyte (CALLY) index and osteoarthritis prevalence: a cross-sectional study of American adults based on NHANES. Frontiers in Nutrition. 2025;12:1710682.
  20. Zierk J, Arzideh F, Rechenauer T, Haeckel R, Rascher W, Metzler M, et al. Age-and sex-specific dynamics in 22 hematologic and biochemical analytes from birth to adolescence. Clinical chemistry. 2015;61(7):964-73.
  21. Moosmann J, Krusemark A, Dittrich S, Ammer T, Rauh M, Woelfle J, et al. Age‐and sex‐specific pediatric reference intervals for neutrophil‐to‐lymphocyte ratio, lymphocyte‐to‐monocyte ratio, and platelet‐to‐lymphocyte ratio. International Journal of Laboratory Hematology. 2022;44(2):296-301.