Diagnostic procedures in pediatric superficial cervical abscesses.

Background: Diagnostic procedures intend to differentiate superficial cervi cal abscesses from deep abscesses and uncomplicated lymphadenitis. They sho uld provide identification of the causing agent, of the route of infection and of possible underlying diseases. Present techniques for examining pedia tric cervical abscesses should be assessed. Methods: Currently published da ta on diagnostic procedures in pediatric neck abscess from National Library of Medicine data files were evaluated. Moreover, clinical findings, diagno stic procedures, therapy and outcome of 47 children with cervical abscess t reated from 1992-1996 were retrospectively evaluated. Results: Studies prov iding appropriate evidence on the value of various diagnostic procedures in pediatric cervical abscesses were not found. In 47 patients with confirmed cervical abscess treated at our department, clinical examination, erythroc yte sedimentation rate and ultrasound examination of the neck were sufficie nt to establish the correct diagnosis. Additional investigations such as MR I or CT-scans, chest X-rays, Mendel-Mantoux test, various virus titres and other laboratory examinations were performed only in selected cases. The ro ute of invasion (tonsil, dental or otogeneous) could be identified in 13 ch ildren. In 4 children an infected cervical cyst was found. Conclusions: Cli nical examination, erythrocyte sedimentation rate and sonography are approp riate to establish the diagnosis of pediatric cervical abscess and in accor dance with the principles of Managed Care.