Pediatric Infections Cluster by Age

“We used an epidemiological approach to determine if we could identify a pattern of development of these infections and if there was a pattern to the risk factors associated with abscesses in a pediatric population,” he said.

A nonparametric Kruskal-Wallis test was used to identify significant differences in the age distributions among the diagnosis groups. A Bonferroni, pairwise comparison procedure was used for comparing the average age of first onset of severe head and neck infections. A chi-square test was used to identify any significant association between season of the year and disease.

In his study, Dr. Schweinfurth identified a total of 1,010 severe head and neck infections cases among patients aged 3 months to 18 years during a five-year period. He noted the differences in age distributions of those infections and the average age of the first onset of the infection.

The most frequent abscess seen was the periapical abscess.

Results Reveal Age, Site Clusters

He found 133 cases of cellulitis and abscesses of the neck—and 59 of those cases occurred during the first year of life. The mean age of occurrence was 5.4 years, but only in one year after the first year of life were there more than 10 such infections recorded in the pediatric population.

On the other hand, cases of peri-tonsillar abscesses were rare before the child was 10 and increased dramatically during the teen years, with 26 of the 81 cases of this infection occurring at age 18. More than five cases a year were seen by children aged 11, 14, 16, 17, and 18. The mean age for this infection was 13.1 years. “A potential explanation may come from the observation that Epstein-Bar virus (EBV) causes more severe infections in the tonsils of adolescents compared to younger children. The abscess is a secondary occurrence from intense local inflammation.”

Dr. Schweinfurth’s hospital recorded 73 cases of pharyngitis and tonsillitis, with most of the cases clustering before age 7. The mean was 6.4 years.

The study found 11 cases of parapharyngeal abscess, all in children 12 years of age or younger. Four of those cases occurred in children 7 to 8 years of age. The mean was 5.8 years.

He scrutinized 92 cases in which pediatric patients had combined peri-tonsillar and parapharyngeal abscesses. Those cases again peaked at the older end of the age spectrum, with 42 of the cases occurring in children ages 15 to 18 years. In contrast, less than 10 of these cases were recorded in children under the age of 5 years. The mean was 12.2 years.