Deep neck infections in cervical injection drug users.

Objectives/hypothesis: To characterize deep neck infections (DNI) in adult intravenous drug users (IDUs) who injected illicit substances to their neck, in comparison to DNI in non-IDUs.

Study Design: Retrospective, cohort study.

Methods: Data were retrieved from medical charts of adult DNI patients in a secondary hospital during 2000-2013. Clinical, radiologic, and microbial data were extracted and tabulated following categorization into 2 patient groups: IDUs and non-IDUs.

Results: Of the 136 patients identified with DNI, 20 (15%) were IDUs; of them 80% were males. IDUs were significantly younger than non-IDUs (mean age, 35 ± 10 vs. 44 ± 16 years, P = .01). All IDUs had multiple comorbidities. IDUs presented for medical examination and hospitalization later in the course of their disease, and the most common involved neck spaces were consistent with areas where cervical injections are commonly performed. Abscess formation was more common in IDUs than non-IDUs (16 [80%] vs. 79 [68%], respectively, P = .04). Despite later presentation of IDUs and their higher rate of comorbidities, laboratory data, microbiology cultures, and disease course were similar to non-IDUs.

Conclusions: Although IDU and non-IDU differ in DNI presentation, both groups had good outcomes. DNI in IDUs frequently evolved into abscesses, and most were found in the anterior triangle deep to sternocleidomastoid (SCM), posterior triangle, and anterior triangle superficial to SCM, in concordance with the injection sites.

Level Of Evidence: 4.