Deep neck infection: The Daily PANCE Blueprint
Which of the following is the best diagnostic test for a suspected deep neck infection?
A. CT of the neck with contrast
B. MRI of the neck
C. Lateral radiograph
D. Ultrasound of the neck
E. CBC, ESR, CRP, ferritin
Answer and topic summary
The answer is A. CT of the neck with contrast
Deep neck infections are uncommon but serious infections that include retropharyngeal abscess (RPA), parapharyngeal abscess (PPA), and peritonsillar abscess (PTA). Clinical features depend on the type of infection but can include a “hot potato” voice, trismus, enlarged tonsils, uvula deviation, neck swelling, fever/chills, neck/throat pain, and signs of sepsis. CT is the imaging modality of choice. Management includes securing the airway if there are signs of airway compromise (inability to manage secretions, etc), IV antibiotics, and aspiration or surgical drainage (if there is a drainable collection). An ID and HEENT consult should be made.
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