Deep Neck Infection
por Leslie Brown
1. Most common in adults=odontogenic & salivary sources
2. often no identifiable source
3. most common affected spatial compartments
3.1. retropharyngeal
3.1.1. lymph nodes generally cause of abscess in area
3.1.2. PE:bulging posterior pharyngeal wall
3.2. Parapharyngeal
3.2.1. tumors usually benign
3.2.2. PE:trismus, stiff neck, dysphagia, & poss. drooling
3.3. Submandibular/submental
3.3.1. most common source=odontogenic
4. LABS:
4.1. CBC
4.2. CMP
4.2.1. include CREATININE
4.3. Culture w/ sensitivity if poss.
5. TREATMENT:
5.1. inpatient
5.1.1. airway manage
5.1.2. IV antibiotics
5.1.2.1. Ampicillin/Sulbactam w/ Metronidazole
5.1.2.2. or clindamycin
5.2. outpatient
5.2.1. oral abx
5.2.1.1. Clindamycin
5.2.1.2. cefuroxime axetil
5.2.2. consider oral steroids
6. could be life threatening
7. most common site in children is pharynx & tonsils
8. Organisms:
8.1. Bacterial
8.1.1. Gram+,Gram-,aerobic & anaerobic
8.1.2. Strep/Staph
8.1.3. H.influenza
8.1.4. Strep pneum.
8.1.5. Moraxella catarrhalis
8.1.6. Klebsiella
8.1.7. Neisseria
8.1.8. Borrela vincentii