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Deep neck cellulitis: a challenging diagnosis
  1. Ana Isabel Gonçalves,
  2. Ditza Vilhena,
  3. Delfim Duarte and
  4. Nuno Trigueiros
  1. Otorhinolaryngology, Pedro Hispano Hospital, Porto, Matosinhos, Portugal
  1. Correspondence to Dr Ana Isabel Gonçalves; gc.anaisabel{at}gmail.com

Abstract

A 38-year-old woman with Crohn’s disease, under immunosuppressive therapy, was referred to the emergency department for severe progressive neck pain and fever, with 1 week of evolution. She was unable to perform neck mobilisation due to the intense pain aroused. She referred dysphagia. Oral cavity, oropharynx, hypopharynx and larynx showed no alterations. She had an increased C reactive protein. Central nervous system infections were excluded by lumbar puncture. CT was normal. Only MRI showed T2 hyperintensity of the retropharyngeal and prevertebral soft tissues of the neck without signs of abscess. The patient was treated with broad spectrum antibiotics. Complications of deep neck infection include abscess formation, venous thrombosis and mediastinitis. In this case, no complications occurred. A high degree of clinical suspicion is essential as deep neck infections need to be promptly diagnosed and treated given their rapidly progressive character, especially in immunocompromised patients.

  • infections
  • ear
  • nose and throat/otolaryngology

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Footnotes

  • Contributors AIG wrote the manuscript. DV, DD and NT were responsible for revising the contents of the manuscript and approving it.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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