Influence of diabetes mellitus on deep neck infection

Abstract

Objective: To investigate the influence of hyperglycaemia on deep neck infection (DNI) and the differences between the diabetic and non-diabetic form of DNI.Study design and setting: Retrospective review of 131 patients with DNI treated between 1993 and 2002 at Shin Kong Memorial Hospital, Taipei, Taiwan.Results: Deep neck infection was significantly more prevalent in patients with diabetes mellitus (DM) over 60 years of age than in non-DM subjects of a similar age (p = 0.004). In the DM group, Klebsiella pneumoniae was the most common aerobic pathogen and tended to involve more than two anatomical spaces (p < 0.0001). Seventeen out of 18 patients (94.4 per cent) displayed an elevated (≥7 per cent) glycosylated haemoglobin level. The DM group had a significantly higher complication rate, longer hospital stay and tracheotomy rate than the non-DM group.Conclusions: Diabetic DNI differs from non-diabetic DNI in several aspects and is associated with a higher morbidity. A greater than normal haemoglobin A1c level was commonly observed.