Demographic and risk factor analysis of deep neck space infections at Cairo university hospitals

Abstract Background Deep neck space infections (DNSI) are rapidly progressing neck infections that commonly originate from odontogenic sources and may lead to severe life-threatening complications. This study aimed to identify demographic characteristics, risk factors, and factors associated with complications of DNSI. Patients and methods This prospective cohort study included 60 patients with DNSI admitted to the Otorhinolaryngology Head and Neck Surgery Department, Kasr Al-Ainy Hospital, Cairo University, between June and December 2021. Patients were divided into two groups: Group A (unilateral submandibular space infection, n = 30) and Group B (bilateral submandibular space infection, n = 30). Demographic data, etiology, laboratory findings, microbiology, treatment, complications, and outcomes were analyzed. Results Among the studied patients, 58.3% were males, and 65% were from urban areas, with a mean age of 38.4 years. Bilateral infections were associated with significantly higher total leukocyte counts (p = 0.004) and a greater incidence of unknown etiology (p = 0.011). Diabetes mellitus was significantly associated with bilateral disease (p = 0.032). Positive cultures were obtained in 70% of the cases, with methicillin-resistant Staphylococcus aureus (MRSA) and non-hemolytic streptococci being the most frequently isolated organisms (23.8% each). All patients underwent surgical drainage, and vancomycin was the most commonly administered antibiotic. Dental extraction was performed in 61.7% of patients and was significantly associated with improved survival. Complications occurred in 21.6% of the patients and were significantly more common in those with bilateral infections (p = 0.001). Septic shock and mediastinitis were the most common complications. Intensive care unit (ICU) admission was required for six patients, all from the bilateral group, with four resulting in mortality. Conclusion Despite antibiotic use, DNSI remain common, particularly among males and urban patients. Effective management requires early airway control, rapid surgical drainage, and appropriate broad-spectrum antibiotics. Odontogenic infection is the main cause, making dental extraction an essential component of treatment. Diabetes mellitus has been identified as the most important risk factor for complications, morbidity, and mortality.