Neck Infection — Inpatient Management — Clinical Pathway: Emergency

Deep Neck Space Infection Clinical Pathway — Emergency Department

Inpatient Management

Inpatient with Deep Neck Space Infection
 
 

 

 
 

 

Non-severe Disease
Severe Disease
 
 

 

 
 

 

 
 

 

 
 

 

Continue antibiotics
Good Clinical Response
 
 

 

Discharge
  • 2 weeks total PO antibiotic(s)
  • Close PMD follow-up
No improvement after 48 - 72 hours
  • Continued fevers/no improvement in fever curve
  • No improvement in neck extension/ROM
  • No improvement in drooling or ability to PO
 
 

 

  • Consult ENT
  • CT Scan of Neck
  • *If a CT requires general anesthesia, discuss coordinating CT and potential surgery under 1 episode of anesthesia with anesthesia and ENT.
  • Consider ID Consult
  • Start antibiotics
  • Consult ENT
  • Consult ID
  • CT Scan of Neck
CT Scan Results Action
No Collection
  • Re-evaluate diagnosis
Collection too small to drain
  • Discuss with ENT & ID consultants
Drainable Collection
  • Drainage and culture by ENT
  • Tailor antibiotics to cultured organism
    • Discharge once culture results are known, tolerating oral antibiotic, and clinically improving
    • Duration of antibiotics is 2 weeks from drainage