Deep neck space infections

Background

• The deep spaces of the neck include
  • Lateral pharyngeal space, which connects to carotid sheath
  • Pretracheal space, which connects to mediastinum and carotid sheath
  • Retropharyngeal space, which connects to mediastinum
  • Danger space, between alar fascia and prevertebral fascia, which communicates with posterior mediastinum

Microbiology

• Oropharyngeal and nasopharyngeal flora, often polymicrobial but with streptococci
• Staphylococcus aureus

Clinical Manifestations

• Fever, dyspnea, dysphagia
• Can progress to cause mediastinitis

Diagnosis

• CT scan

Management

• Surgical debridement
• Broad-spectrum antibiotics to cover oral flora