Deep Neck Infection

MICROBIAL ETIOLOGY Anaerobes generally outnumber aerobes at all sites by a factor of 10:1 While anaerobes are likely to be involved in most deep neck infections, a small but significant proportion of cases will also contain other pathogens. Infections involving these additional organisms, such as Staphylococcus aureus and facultative Gram negative rods, including Pseudomonas aeruginosa, are more common in immunocompromised patients.

Symptoms Sorethroat and trismus. Dysphagia and odynophagia Dysphonia and hoarseness Unilateral tongue paresis Stridor and dyspnea

THERAPEUTIC RECOMMENDATIONS (immunocompetent) Ampicillin-sulbactam(Unasyn) - (2 g IV every four hours) Penicillin G (2 to 4 MU IV every four to six hours) plus metronidazole (500 mg IV every six hours) Clindamycin (600 mg IV every six hours)

THERAPEUTIC RECOMMENDATIONS (immunocompromised ) Vancomycin Cefotaxime (Claforan) Ceftizoxime Imipenem Piperacillin-tazobactam (Tazocin)