Neonatal and Pediatric Head and Neck Infections: A Six-Decade Evidence Synthesis
Khatri LK, More AB, Govani PS, Zaparackaite I, More BB, Singh SJ, Swamy KB, Mehta AR, Midha PK, Patel RV
Citation: Khatri LK, More AB, Govani PS, Zaparackaite I, More BB, Singh SJ, Swamy KB, Mehta AR, Midha PK, Patel RV, "Neonatal and Pediatric Head and Neck Infections: A Six-Decade Evidence Synthesis", OAS Journal of Medical and Health Sciences, Volume 01, Issue 01.
Copyright: This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Neonatal and pediatric head and neck infections encompass a wide clinical spectrum ranging from mild mucosal inflammation to rapidly progressive, life-threatening deep neck space infections. Neonates present unique diagnostic challenges due to immature immunity, atypical early signs, and higher risk of systemic involvement. In older children, evolving microbiology, increasing antimicrobial resistance, and changing epidemiology have reshaped diagnostic and therapeutic strategies.
Methods: This six-decade evidence synthesis integrates neonatal and pediatric infectious disease literature, surgical case series, microbiological trends, and contemporary imaging-based diagnostic pathways. Emphasis is placed on mechanism-specific classification, anatomical spread, and decision-making frameworks relevant to emergency, pediatric, and surgical practice.
Results: Neonatal infections—including mastitis, suppurative parotitis, cervical cellulitis, and early deep neck infections—are predominantly caused by Staphylococcus aureus, GBS, and Gram-negative organisms. Pediatric infections demonstrate broader etiologies, with significant contributions from Fusobacterium necrophorum, Kingella kingae, atypical mycobacteria, and community-acquired MRSA. Retropharyngeal and parapharyngeal abscesses remain the most clinically significant deep neck infections, with CT and MRI central to evaluation. Congenital anomalies such as thyroglossal duct cysts and bronchogenic cysts frequently mimic infection in infants. Complications include airway compromise, mediastinitis, venous thrombosis, and cranial nerve deficits.
Conclusion: A mechanism-based, anatomy-guided approach improves diagnostic accuracy, optimises imaging selection, and supports timely surgical intervention. This synthesis provides clinicians with an updated, practical framework for recognising, investigating, and managing neonatal and pediatric head and neck infections in contemporary practice.
Keywords: Neonatal Infections; Pediatric Head and Neck Infections; Deep Neck Space; Retropharyngeal Abscess; Parapharyngeal Abscess; Cervical Lymphadenitis; Congenital Cysts; Mediastinitis; Pediatric Surgery.
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