What are the possible complications of deep neck infections?

Updated: Apr 30, 2020
  • Author: Alan D Murray, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Deep neck infections have many severe life-threatening potential complications. Deep neck infections that are not treated or are inadequately treated, those that extend to other deep neck spaces, and those that are complicated by a delay in diagnosis and treatment are at particular risk of complications, including the following:

  • Airway obstruction from compression of the trachea

  • Aspiration

    • This is particularly due to perforation of a retropharyngeal abscess with drainage of pus into the airway.

    • Aspiration may occur spontaneously or during endotracheal intubation.

  • Vascular complications (ie, thrombosis of the internal jugular vein, carotid artery erosion and rupture)

  • Mediastinitis from inferior spread along fascial lines

  • Neurologic deficits: Cranial nerve dysfunction or dysfunction of the autonomic nerves in the neck can lead to problems such as hoarseness from involvement of the vagus in the carotid sheath or Horner syndrome from involvement of the sympathetic chain.

  • Septic emboli: These emboli can lead to pulmonary, brain, or joint seeding and resultant abscesses.

  • Septic shock

  • Necrotizing cervical fasciitis: This is a fulminant infection involving necrosis of the connective tissue that spreads via fascial planes. It has particularly high morbidity and mortality rates.

  • Osteomyelitis due to local spread to bones of the spine, mandible, or skull base

  • Grisel syndrome (ie, inflammatory torticollis causing cervical vertebral subluxation)

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