Deep neck cellulitis: limitations of conservative treatment with antibiotics

When the parapharyngeal space is infected, concurrent involvement of other spaces is likely, and involvement of multiple deep neck spaces is a key risk factor for abscess formation.

Deep neck infection is treated with antibiotics when abscesses have not yet been formed. However, in some cases, abscesses will form later and surgical drainage is warranted. This study retrospectively examined which cases were less likely to achieve cure, to clarify the limitations of conservative treatment for deep neck cellulitis.

Subjects comprised 19 patients with deep neck cellulitis who initially underwent conservative treatment with antibiotics. Patients were divided into two groups: Group A (n = 7), patients who recovered by conservative treatment; and Group B (n = 12), patients who did not recover and underwent surgical drainage. Age, state of DM control, etiology, treatment, spaces infected, and duration of hospitalization were investigated.

The number of infected spaces was one in all Group A patients, whereas Group B showed multiple infected spaces in all except two cases. In particular, among the 10 cases with parapharyngeal space infection, eight (80%) showed multiple lesions.