Management of superficial neck abscesses.

OBJECTIVE To evaluate clinical features, management options and outcomes in children with neck abscesses, with a view to correlating this data with the different causative micro-organisms, specifically mycobacteria. PATIENTS AND METHODS A retrospective chart review of fifty-one consecutive children who were admitted with suspected superficial neck abscesses to the Unit between January 1994 and June 1999 was performed. RESULTS The causative organisms were identified in 21 cases--bacteria in 13 patients, atypical mycobacteria in 6 cases, and mycobacterium tuberculosis in 2 instances. Children with atypical mycobacterial infection had a significantly longer duration of symptoms at the time of admission (mean = 87 days) versus those with bacterial infection (mean = 6 days). Ultrasonography was performed in 20 patients in this series, and was seen to be of value in demonstrating a collection in situations where there was doubt on clinical basis alone. The outcome was seen to be complicated in all children with mycobacterial infections--either atypical or tuberculous. CONCLUSIONS Neck abscesses are commonly encountered in paediatric practice. In most instances the diagnosis and treatment is straightforward, with an uncomplicated outcome. However, it is important to bear in mind that there exists a subset of abscesses caused by atypical mycobacteria, with greater risk of complications and recurrence, that needs special attention at the time of diagnosis, intervention and follow-up.