The Characteristic of Neck Abscess Patients at Sanglah General Hospital Denpasar in January , 1 st – December , 31 th 2014

Deep neck abscess is an abscess formed in potential space in neck fascia resulted by infection deployment from various sources like teeth, mouth, throat, paranasal sinus, ear, and neck. This research was a retrospective descriptive study design with secondary data from all the neck abscess patient’s medical record treated in RSUP Sanglah Denpasar. Twenty nine patients with neck abscess are included in this study with characteristic assessment related to gender, age, complaint, diagnosis, germs culture, antibiotic sensitivity, length of stay in hospital, commorbid factor, and complication. The subject is patient with deep neck abscess admitted in RSUP Sanglah from January until December 2014 with gender distribution of men (75,86%) and women (24,14%), with average age of 50,33 years old. Keyword: Deep neck abscess, Characteristic, Infection, RSUP Sanglah.


INTRODUCTION
A deep neck abscess is an abscess formed in a potential space between the deep neck fascia as a result of the spread of infection from various sources such as teeth, mouth, throat, paranasal sinus, ear and neck. 1,2,3e incidence of deep neck abscesses is higher in the pre-antibiotic era but remains as an important problem in third world countries leading to morbidity and mortality.In the pre antibiotic era, 70% was coming from the infection deployment from the pharynx and tonsils whereas today they are mostly caused by dental infections. 4deep neck abscess can lead into serious fatal complications such as airway obstruction, pneumonia, lung abscess, mediastinitis, pericarditis and internal jugular venous thrombosis. 5,6sides doing abscess drainage, antibiotics are also needed for more adequate treatment.To get an effective antibiotic against the patient, it is necessary to examine the bacterial culture and antibiotic susceptibility test against germs.However, this takes a long time so it is necessary to provide an antibiotic empirically. 3,7od knowledge about the fascia anatomy and the potential neck spaces and causes of neck abscess is absolutely necessary to predict adequate deployment and management.

Research Design
This study used a retrospective descriptive research design by taking secondary data from medical records of neck infection patients who went to RSUP Sanglah Denpasar.

Sample Research
Sampling is done by consecutive sampling, every patient who fulfill the inclusion criteria of the research is included as the research sample.Inclusion criteria in this study were patients diagnosed with a deep neck abscess and treated to RSUP Sanglah Denpasar from January 2014 to December 2014.Exclusion criteria were patients with incomplete medical records.

Data Collection Method
Data was taken from medical records of patients diagnosed with neck infection and treated in RSUP Sanglah Denpasar.The examination results are recorded in the data collection sheets for further analysis.

Data processing
The results are presented descriptively in the form of tables and narratives.

DISCUSSION
In a study conducted by Huang et al 14 , from 185 cases of deep neck abscess, we obtained 58.9% of patients were found men and 41.1% of patients were women.Suebara et al 15 reported that from the total of 80 cases of deep neck abscess, we found 69% of the patient were males and 31% were women.In this study, as much as 75.86% of patients were male and 24.14% of patients were female.
According to Gorjon and colleague 16 , the average age of people with deep neck abscess is 37.2 years.In a study conducted by Huang et al 14  zSuebara and colleague 15 , reported that as many as 23.75% of patients with deep neck abscess is complicated by diabetes mellitus, 17.5% of patients with hypertension, 11.25% with heart disease, 8.75% with cancer, 5% with lung disease, 3.75% with HIV infection and 3.75% as a drug user.Huang et al 14 , in his study found that as many as 34.1% of patients with deep neck abscess is comorbid by systemic disease, 88.8% with diabetes mellitus, 9.5% with uremia or chronic renal failure, 4.8% of patients with liver cirrhosis, 2.4 % of patients with myelodysplastic syndrome and as many as 1.2% of patients with malignancy in the stomach undergoing chemotherapy.In this study, 89.65% of patients was without complications and as many as 3 patients or 10.35% with complicated factors namely diabetes mellitus, CKD and ACKD.
Huang and colleague 14 said on his study, the length of treatment in patients with deep neck abscess was in the average of 13 days.Patients with diabetes mellitus was 19.7 days, patients with complication, the average is 27.3 days.In this study, the average length of treatment in patients with deep neck abscess was 8.8 days.
Huang et al 14 also reported that as many as 16.2% of patients was present with complications, while in this study, just 13.78% of patients that had complications.

Table 4 : Characteristic of deep neck abscess based on location
Based on table 6, characteristic of deep neck abscess based on length of stay in hospital, the most was 4 and 6 days, each much as 5 patients or 17,24%.The least one was 9, 11, 15, 20, 21, 33 days, as much as 1 patient (3,45%), each.The average of stay in hospital for deep neck abscess in this study was 8,8 days.

Table 6 : Characteristic of deep neck abscess based on length of stay in hospital Length of N Percentage stay (days) (%)
, we obtained the average age of patients with deep neck abscesses is 49.5 years.Suebara and colleague 15 in his study, reported the average age of patients with a deep neck abscess was 37.1 years.Yang et al 7 in his study, demonstrated that the average age of people with deep neck abscesses was 49.2 years.While in this study, the average age of patients with deep neck abscess is 50.33 years.

Table 5 : Characteristic of deep neck abscess based on comorbidity factor
Twenty-nine patients with a deep neck abscess were included in this study, by assessing the characteristics associated with gender, age, complaint, diagnosis, length of stay in hospital, comorbid factor and complications.Patients with deep neck abscess who came to RSUP Sanglah from January to December 2014, has a gender distribution as male in 75.86% and female as much as 24.14% with average age of 50,33 years.Patients with the most diagnosis of deep neck abscess is peritonsiler abscess, as much as 31,04%.As many as 100% of people with deep neck abscesses presented with clinical symptoms of pain.Patients with deep neck abscess as much as 89,65% has no complication factor.The average length of treatment in patients with deep neck abscess in this study was 8.8 days.86,22% of patients with deep neck abscess presented with no complication.