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Pediatric abscess incidence may be higher postpandemic
Head and neck abscess incidence was more than 3-fold higher following the pandemic, while patient characteristics and treatment patterns remained largely similar.
To evaluate the incidence of pediatric head and neck abscesses across different periods: prepandemic, during COVID-19 lockdown, and postpandemic.
Approach:
Study Design: Retrospective cohort study of 194 patients aged 18 years or younger with confirmed head and neck abscesses treated at Children’s Nebraska and the University of Nebraska Medical Center from January 2017 to December 2024.
Incidence Calculation: Incidence was calculated using unique pediatric emergency department patients in each period to account for differences in health care utilization.
Secondary Assessments: Included patient demographics, clinical presentation, microbiology, abscess size, treatment details, and duration.
Key Findings:
Postpandemic incidence of head and neck abscesses was 3.28-fold higher than the prepandemic incidence.
Incidence increased from 3.34 cases per 10,000 ED patients per year prepandemic to 6.13 during lockdown and 10.95 postpandemic.
Postpandemic incidence was significantly higher for cervical lymphadenitis with abscess, peritonsillar abscess, retropharyngeal or parapharyngeal abscess, and the 'other' category, which included intracranial, laryngeal, intraorbital, and intratonsillar abscesses.
No significant differences in patient demographics or clinical management across periods.
Microbiologic findings were consistent with expected organisms; no new dominant pathogens identified.
Interpretation:
The increase in pediatric head and neck abscesses persisted postpandemic despite similar demographic and treatment characteristics.
Limitations:
Study limited to eastern Nebraska, affecting generalizability.
Small prepandemic and lockdown cohorts reduced statistical power.
Incomplete microbiologic data and lack of systematic collection of airway compromise and ICU admissions.
Conclusion:
The findings indicate a need for ongoing surveillance and prompt recognition of pediatric infections in the post-pandemic era.
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