A Prospective Study on the Evaluation and Management of Deep Neck Space Infections: Clinical Presentation, Microbiological Profile, Radiological Findings, Treatment Modalities, and Complications

Abstract

Background: Deep neck space infections (DNSIs) are potentially life-threatening infections that may lead to airway compromise and other serious complications. Early diagnosis and appropriate management are essential for favourable outcomes.

Aim: To evaluate the clinical presentation, microbiological profile, radiological findings, treatment modalities, and complications of deep neck space infections.

Materials and Methods: A prospective observational study was conducted in the Department of Otorhinolaryngology, Kodagu Institute of Medical Sciences, Madikeri, over 6 months. A total of 64 patients aged ≥18 years with deep neck space infections were evaluated. Clinical findings, laboratory parameters, microbiological results, CECT findings, treatment modalities, complications, and outcomes were recorded and analysed.

Results: Males constituted 62.5% of patients, with a mean age of 45.3 ± 14.2 years. Fever (81.3%), neck swelling (73.4%), and neck pain (70.3%) were the commonest presentations. The submandibular space was most frequently involved (26.6%). Abscess formation was identified in 71.9% of patients on imaging. Culture positivity was observed in 39 patients, with Streptococcus species being the commonest isolates. Surgical drainage was required in 44 patients, while airway intervention was required in 8 patients. Overall, 89.1% of patients showed clinical improvement, with a mortality rate of 3.1%.

Conclusion: Deep neck space infections require early clinical recognition, appropriate CECT evaluation, antimicrobial therapy, timely surgical drainage, and vigilant airway management to minimize complications and mortality.