Deep neck space infections: a UK centre, two-year, retrospective review of 53 cases

Objective: This retrospective study comprehensively assesses clinical characteristics, management, outcomes, and complications of deep neck space infections in adults at a UK ear, nose and throat tertiary centre.

Methods: Adult deep neck space infection patients from April 2019 to March 2021 were retrospectively reviewed using health records and picture archiving and communication system data. Demographics, presentation, microbiology, treatment, complications, and outcomes were analysed.

Results: Fifty-three patients (mean age: 53.8 years, M:F ratio 1.5:1) were studied. Deep neck space infections were polymicrobial in 29.4 per cent, with Streptococcus milleri group (64.7 per cent) occurring most frequently. Complications occurred in 20.8 per cent, including mediastinitis (13.2 per cent) and Lemierre's syndrome (7.5 per cent). Mortality was 5.7 per cent. Treatment included intensive care admission (32.1 per cent), tracheostomy (15.1 per cent), medical management alone (39.6 per cent), bedside peritonsillar abscess drainage (18.9 per cent), transcervical drainage (28.3 per cent), transoral drainage (13.2 per cent), and hot tonsillectomy (5.7 per cent). Patient age correlated with length of stay.

Conclusion: The study highlights deep neck space infection complexity, emphasising tailored management, effective antibiotics, and frequency and severity of complications. Comprehensive understanding of deep neck space infections can improve care and outcomes.