Infected intramedullary clavicle nail presenting as neck abscess-a case report and a caveat

Background

The investing layer of deep cervical fascia is responsible for the transmission of deep neck space infection from the pharyngeal spaces to the mediastinal spaces. In orthopaedic procedures, implants are a constant source of infection, both early on and afterward. When infected, intra-medullary implants are a constant source of danger that goes undetected and acts as an infection focus.

Case report

We report the case of forty-one-year-old man with a deep neck space infection and para-tonsillar abscess which was later diagnosed to be an extension of an infected intra-medullary clavicle implant.

Conclusion

Infection of implants used for internal fixation of clavicle can spread to the neck rapidly and present as a deep neck space infection and abscess. This case report should alert Orthopaedic Surgeons to this possibility and ensure that implant removal is done at the earliest once such infection is suspected.