Deep neck infections in cervical injection drug users.
OBJECTIVE
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.


METHODS
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.


METHODS
4.
Department of Otolaryngology-Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel.
Sharon O
SO
Tamir
Department of Otolaryngology-Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel.
Tal
T
Marom
Department of Otolaryngology-Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel.
Assaf
A
Len
Department of Otolaryngology-Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel.
Ofer
O
Gluck
Department of Otolaryngology-Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel.
Abraham
A
Goldfarb
Department of Otolaryngology-Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel.
Yehudah
Y
Roth
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007239:Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009333:Neck; D012189:Retrospective Studies; D015819:Substance Abuse, Intravenous / Q000150:complications*; D055815:Young Adult
Deep neck infection; complication; foreign body; hepatitis C virus; intravenous drugs users