Deep neck infections are urgent and common conditions that can be life-threatening for people of all ages. To prevent serious complications, it is important to follow a thorough and quick algorithm in every case. The neck fasciae divide the head and neck into compartments, which determine the risk of inflammation spreading to nearby or distant areas. The deep neck spaces are complex and have a predictable pattern of communication. The infected compartment provides information about the possible site of the original infection and guides the management of the condition. In children, acute Waldeyer’s ring inflammations and dental infections (biofilms) are the main causes, and in adults, dental infections are more common. It is worth noting that methicillin-resistant Staphylococcus aureus (MRSA) is the most common pathogen in children under 24 months of age. Although surgical management with drainage is usually the preferred treatment, the first priority should secure a threatened or potentially threatened airway through formal intubation or an emergent tracheostomy. Therefore, a computed tomography (CT) scan and its valuable information may not always be feasible. Conservative management with antibiotics and without drainage should only be considered in cases where there is involvement of a single neck space and an abscess cavity measuring less than 2.5 in. in its highest dimension. The presence of acute or progressive neurological symptoms is a worrisome sign and indicates the spread of infection throughout the body.

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Deep Neck Space Infections

  • Alexandros Poutoglidis,
  • Paraskevi Karamitsou

摘要

Deep neck infections are urgent and common conditions that can be life-threatening for people of all ages. To prevent serious complications, it is important to follow a thorough and quick algorithm in every case. The neck fasciae divide the head and neck into compartments, which determine the risk of inflammation spreading to nearby or distant areas. The deep neck spaces are complex and have a predictable pattern of communication. The infected compartment provides information about the possible site of the original infection and guides the management of the condition. In children, acute Waldeyer’s ring inflammations and dental infections (biofilms) are the main causes, and in adults, dental infections are more common. It is worth noting that methicillin-resistant Staphylococcus aureus (MRSA) is the most common pathogen in children under 24 months of age. Although surgical management with drainage is usually the preferred treatment, the first priority should secure a threatened or potentially threatened airway through formal intubation or an emergent tracheostomy. Therefore, a computed tomography (CT) scan and its valuable information may not always be feasible. Conservative management with antibiotics and without drainage should only be considered in cases where there is involvement of a single neck space and an abscess cavity measuring less than 2.5 in. in its highest dimension. The presence of acute or progressive neurological symptoms is a worrisome sign and indicates the spread of infection throughout the body.