PANCE Blueprint EENT (7%)

Deep neck infection

Patient will present as → an 51-year-old male patient who underwent extraction of the mandibular right third molar. Seven days after the surgery, the patient developed facial edema, fever, intraoral purulent discharge and extreme local pain.  Infectious cavities in the right and left submandibular, pterygomandibular and pharyngeal regions were observed on computed tomography scans.

Deep neck space infections most commonly arise from a septic focus of the mandibular teeth, tonsils, parotid gland, deep cervical lymph nodes, middle ear, or sinuses

  • Deep neck space infections often have a rapid onset and can progress to life-threatening complications
  • Classic manifestations of these infections include high fever, systemic toxicity, and local signs of erythema, edema, and fluctuance

Computed tomography (CT) is the imaging modality of choice for the diagnosis of deep neck space infection

  • MRI is useful for assessing the extent of soft tissue involvement and for delineating vascular complications
  • Plain radiography is of limited utility for the evaluation of deep neck space infection

The most common organisms isolated from deep neck space infections are viridans streptococci

  • For deep neck space infections that involve a drainable collection, aspiration or surgical drainage should be performed
  • Antibiotic treatment depends on the location of infection - options include nafcillin, vancomycin, ciprofloxacin etc.
  • For parapharyngeal, retropharyngeal, or prevertebral space infections, therapy should generally be continued for two to three weeks
Oral Candidiasis (ReelDx) (Prev Lesson)
(Next Lesson) Epiglottitis
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