Clinical characteristics and pathogenetic analysis of piriform fossa fistula complicated with infection in pediatric patients
Objective To investigate the clinical and pathogenetic characteristics of piriform fossa fistula with infection in pediatric patients.Methods The clinical data of pediatric patients with piriform fossa fistula complicated by neck abscess were retrospectively collected from the First Affiliated Hospital of Zhengzhou University between January 2013-December 2022 as the case group.The case group comprised 39 patients(25 males,14 females)with an age range of 24.0 to 192.0 months(mean age=107.0±55.0 months;median age=96.0 months).The control group consisted of children with non-piriform fossa fistula neck abscess.The control group included 25 patients(13 males,12 females)aged between 14.0-192.0 months(mean age=96.0±59.0 months;median age=92.0 months).Both groups were under 16.0 years old and had normal immunity.Ultrasound-guided puncture or incision drainage was performed,and pus samples were collected for bacterial culture.Positive results were included,and pathogen characteristics between the groups were compared and statistically analyzed.Results In the case group,lesions were located on the left side in 33 cases,right side in five ca-ses,and both sides in one case.Pus culture revealed streptococcus anginosus group in 22 cases(56.4％)and non-strep-tococcus anginosus group in 17 cases(43.6％).In the control group,lesions were found on the left side in 19 cases,right side in five cases,and both sides in one case.Pus culture results showed four cases(16％)of streptococcus anginosus group and 21 cases(84％)of non-streptococcus anginosus group.There were no significant differences between the two groups in terms of age(P=0.451),gender(P=0.336),and laterality of the lesion(P=0.656).However,the distribution of streptococcus anginosus group between the two groups was statistically significant(P=0.001).Conclusion In children with piriform fossa fistula complicated by infection,the condition can manifest at various ages,predominantly affecting the left neck region,and streptococcus anginosus group is commonly im-plicated as the causative pathogen.Prompt intervention such as puncture or incision drainage is recommended once abscess formation occurs,followed by administration of appropriate antibiotics based on sensitivity testing.
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