Deep cervical abscesses are defined by the presence of pus in the spaces and fasciae of the head and neck, secondary to the extension of dental or upper respiratory tract infections. These infections can be categorized into different types depending on their location and have a high mortality if not diagnosed early. Common causes include tonsillitis, dental infections, oral surgical procedures, trauma, and foreign body aspiration. Diagnosis involves symptoms like dysphagia, odynophagia, dysphonia, and imaging tests like CT scans. Treatment recommended is empirical medical treatment with antibiotics like third generation cephalosporins and metronidazole, along with potential puncture drainage.

1. Deep cervical abscesses
Salazar Jasso Raúl

2. • Is defined by the presence of pus in
the spaces and fasciae of the head and
neck.
• Deep neck abscesses are secondary to
the extension of dental or upper
respiratory tract, which extends along
the deep levels of deep cervical fascia.
• These infections have a high mortality
if they are not diagnosed in an early
stage

3. Can be categorized into :
• Retropharyngeal
• Peritonsillar
• Masseteric
• pteropalatine maxillary
• Parapharyngeal
• Submandibular
• parotid
• floor of mouth abscesses.

5. • It occurs with considerable
frequency and its severity and
extent may be underestimated,
making this entity diagnostic
challenge to the medical team
because clinical signs and
symptoms often overlap with
those of other common clinical
pictures (i.e. pharyngitis,
tonsillitis and torticollis

6. Tonsillitis remains the most
common etiology of deep neck
space infections in children
1
Odontogenic origin is the most
common etiology in adults.
2

7. Etiology

9. • Tonsillar and pharyngeal infections
• Dental infections or abscesses
• Oral surgical procedures or removal of suspension wires
• Salivary gland infection or obstruction
• Trauma to the oral cavity and pharynx (eg, gun shot wounds,
pharynx injury caused by falls onto pencils or Popsicle sticks,
esophageal lacerations from ingestion of fish bones or other
sharp objects)
• Instrumentation, particularly from esophagoscopy or
bronchoscopy
• Foreign body aspiration
• Cervical lymphadenitis

10. Frequent bacterial
agents
• Streptococcus Viridans
• Streptococcus beta and alpha
hemolític
• Klebsiella Neumoniae
• Neisseria
• Pseudomona
• Staphylococcus epidermidis

11. Diagnosis

12. • Dysphagia
• Odynophagia
• Dysphonia
• Trismus
• Fever

13. • Increased neck volumen

14. Diagnostic tests

15. Leukocyte Account
•Leukocytosis,
indicates an
infectious
process.
•In patients with
immunocomprom
ise or in septic
patients we can
find leukopenia

16. Computed tomography (CT)
• Is the study of
most useful
image for
diagnosis and
plan surgical

18. Magnetic resonance
imaging (MRI)
• They are useful
for diagnosing
DNI, and there
are even reports
where the latter
has demonstrated
advantages over
CT.

20. Radiography
•Contribute
limited
information and
may show track
deviation Aerial
or increased
retropharyngeal
space.

22. Treatment

23. IT IS RECOMMENDED TO START WITH EMPIRICAL
MEDICAL TREATMENT
1. 3rd generation
cephalosporins such as:
cefotaxime, ceftazidime,
ceftriaxone, etc at doses of 1 to 2
grams IV every 8 hours.
2. Metronidazole 500mg IV
every 8 hours and / or
clindamycin 600 mg every 8
hours

24. Puncture
drainage

25. Bibliography
• Diagnóstico y Tratamiento del ABSCESO PROFUNDO DE CUELLO. Catálogo Maestro de
Guías de Práctica Clínica: IMSS-326-10
• Dra. Roxana Spinia , Dra. Elena Ariasb , Dr. Lucas Bordinoa , Dra. Daniela Cohenb y Dr.
Julián Michalski, Deep neck infections. Report of three pediatric cases, Arch Argent
Pediatr 2017;115(5):e302-e306 /
• Brito TP, Hazboun IM, Fernandes FL, Bento LR, Zappelini CE, Chone CT, et al. Deep neck
abscesses: study of 101 cases. Braz J Otorhinolaryngol. 2017;83:341-8.
• Vieira F, Allen SM, Stocks RSM, Thompson JW. Deep neck infection. Otolaryngol Clin N
Am 2008; 41:459-83.
• Lee YQ, Kanagalingam J. Bacteriology of deep neck abscesses: a retrospective review of
96 consecutive cases. Singapore Med J 2011; 52:351-5