Neck cellulitis is an acute diffuse suppurative inflammation of the loose connective tissue in the neck.
Etiology and Pathogenesis
In addition to local factors such as upper respiratory infections, odontogenic infections, foreign bodies in the upper respiratory or digestive tract, and neck trauma, some cases have unknown causes that may be related to immune suppression resulting from conditions such as diabetes, rheumatoid arthritis, radiotherapy, chemotherapy, or malnutrition.
The infection often involves mixed pathogenic microorganisms. Aerobic pathogens predominantly include Gram-positive bacteria, such as Streptococcus and Staphylococcus species, while anaerobic pathogens primarily consist of Prevotella and Bacteroides species.
Clinical Manifestations
In superficial neck cellulitis, the affected area exhibits significant redness, swelling, heat, and pain. The lesion expands rapidly and lacks clear boundaries with the surrounding normal tissue. Necrosis may occur in the central area of the lesion due to ischemia.
In deep neck cellulitis, local redness and swelling are often not prominent, but systemic symptoms are severe. Patients frequently experience high fever, chills, headache, and generalized weakness. In severe cases, complications such as laryngeal edema may develop, which can compress the trachea and esophagus, leading to respiratory distress and difficulty swallowing. If the inflammation extends downward, it may result in mediastinitis or mediastinal abscesses—conditions that are highly dangerous and require urgent intervention.
Treatment
Local Treatment
Thermal therapy, including warm compresses or physical therapy, serves to alleviate the inflammation.
Systemic Treatment
Measures include the following:
- Ensuring adequate rest and providing nutritional support.
- Administering appropriate antibiotics with proven efficacy against the bacteria involved.
- For patients with diabetes, maintaining effective blood sugar control.
Surgical Treatment
In cases where abscess formation has occurred, surgical incision and drainage are necessary to facilitate the evacuation of pus.