The incidence of serious head and neck infections (HNI) among children in the United States has surged dramatically since 2021, according to a new study. This nationwide analysis, conducted using deidentified electronic medical records from over 80 healthcare networks, highlights a concerning 104% increase in pediatric cases, signaling an alarming post-pandemic health trend that demands urgent attention from clinicians.
The study analyzed data from 2018 to 2023, focusing on hospitalized patients under 18 years old with serious HNI, including orbital and mastoid infections, using ICD-10 diagnostic codes. Over the six-year period, the average age at diagnosis was 11.6 years in the pediatric group, compared to 53.6 years in adults. While adult HNI cases remained stable, pediatric cases decreased during the early COVID-19 pandemic (2018–2021) but then saw a dramatic uptick from 2021 onward.
The numbers are striking: from 271 cases per 100,000 in 2018 and 2019, the rate dropped to 214 per 100,000 in 2021 during the height of pandemic-related precautions. By 2023, however, incidence in children more than doubled, surpassing pre-pandemic levels. In contrast, the incidence of nontransmissible osteomyelitis and serious HNI in adults remained stable over the study period, suggesting a unique shift in pediatric trends.
The study identifies streptococcal and staphylococcal species as predominant pathogens, though the specific factors driving the increase in pediatric cases remain unclear. Researchers hypothesize that post-pandemic changes in healthcare-seeking behavior, environmental exposure, and immune susceptibility may contribute to the surge.
Healthcare professionals are urged to be vigilant in recognizing and treating serious head and neck infections in children, given their rising prevalence and potential complications. The findings underscore the need for further investigation into underlying causes and mitigation strategies to address this troubling trend.
For clinicians, this study serves as a critical reminder of the evolving epidemiology of infectious diseases in pediatric populations post-pandemic, requiring prompt adaptation in both diagnosis and management approaches.
Reference: Tsai SYC et al. Increasing Incidence of Serious Head and Neck Infections among Children in the United States, 2018-2023. J Pediatr. 2025. 279(114458).
Anaya Malik | AMJ
