A Rare Deep Neck Infection Associated with COVID: Etiology - Cytomegalovirus

Area of Science:

• Infectious Diseases
• Otolaryngology
• Virology

Background:

• Deep neck infections are serious, potentially life-threatening conditions originating from the oral cavity or oropharynx.
• Standard treatments typically target bacterial and fungal pathogens.
• Geriatric patients with comorbidities like diabetes mellitus and prior COVID-19 infection may present unique challenges.

Purpose of the Study:

• To highlight Cytomegalovirus (CMV) as a potential cause of treatment-resistant deep neck infections.
• To emphasize the importance of considering rare pathogens in refractory cases.
• To showcase the diagnostic utility of tissue sampling and molecular methods.

Main Methods:

• Case report of two geriatric patients with deep neck infections.
• Evaluation of treatment response to antibiotics and antifungals.
• Diagnostic confirmation of Cytomegalovirus (CMV) using tissue samples and molecular assays (CMV DNA PCR).
• Assessment of clinical improvement following antiviral therapy.

Main Results:

• Both patients presented with deep neck infections unresponsive to conventional antibiotic and antifungal treatments.
• Initial blood tests for CMV were negative, but tissue samples confirmed CMV positivity.
• Initiation of antiviral therapy led to significant clinical improvement in both cases.

Conclusions:

• Cytomegalovirus (CMV) should be considered in the differential diagnosis of deep neck infections, especially in immunocompromised patients or those with a history of CMV exposure.
• Tissue sampling and molecular diagnostics are vital for identifying uncommon pathogens like CMV when conventional tests yield negative results.
• Antiviral therapy can be effective in managing CMV-induced deep neck infections.