Infecciones cervicales profundas: de la sospecha clínica a la intervención oportuna

Abstract

Deep neck infections are uncommon but potentially severe entities that may become life-threatening. They typically arise from septic foci in the head and neck, most frequently of odontogenic origin, and exhibit a polymicrobial etiology dominated by anaerobes and streptococci. The complex fascial anatomy of the neck facilitates their spread into deep spaces and, in advanced cases, into the mediastinum. Clinically, odynophagia, dysphagia, fever, and cervical pain predominate, and airway compromise may occur in more advanced presentations. Contrast-enhanced computed tomography is the diagnostic modality of choice. Management involves broad-spectrum empirical antibiotic therapy, strict airway monitoring, and surgical or image-guided drainage depending on patient characteristics and the extent of disease. Despite therapeutic advances, complications such as mediastinitis, Lemierre's syndrome and vascular erosions continue to be associated with high morbidity and mortality. The objective of this review is to provide a comprehensive overview of deep neck infections, emphasizing the importance of early clinical suspicion and prompt intervention.