What is a Neck Abscess?

A neck abscess is condition where there is accumulation of pus due to infection in the spaces present between the structures of the neck. As the collection of the pus increases, there is expansion of the spaces of the soft tissue, which push against the structures in the neck, such as tongue, throat, and in more severe cases, the windpipe or trachea. Neck is a very sensitive area for an abscess to be formed and can become potentially serious if not treated promptly. Neck abscesses are also known as cervical abscesses or deep neck infections. A neck abscess can also be a superficial neck abscess, where it is formed in a superficial layer of the neck; or a deep neck abscess where the abscess is formed in the deeper layers of the neck. A neck abscess can become serious if left untreated, as if it grows in size, it can compress the trachea or the wind pipe causing problems with breathing. Treatment of a neck abscess comprises of medications, such as antibiotics, and drainage of the abscess if needed.

What is a Neck Abscess?

Types of Neck Abscess

  • Superficial Neck Abscess: Superficial neck abscesses are the abscesses, which are located on the superficial layer of the neck, i.e. just below the skin. Superficial neck abscesses commonly form as a result of cervical lymphadenitis, which is infection in lymph node present in the neck resulting in an abscess. Streptococcus or Staphylococcus bacteria are the most common cause of superficial neck abscess. Antibiotics are prescribed for treating superficial neck abscess and if they are not resolved by oral antibiotics then the abscess needs to be drained.
  • Deep Neck Abscesses: Deep Neck Abscesses are the abscesses, which are formed in the deep layers of the neck.
  • Retropharyngeal Abscess: This type of neck abscess is formed at the back of the throat or behind the pharynx. Retropharyngeal abscess commonly develops after an upper respiratory infection. The cervical lymph nodes or the lymph nodes present in the neck region become infected and with formation of pus in them. Young children are more prone to developing retropharyngeal abscesses.
  • Ludwig's Angina or Submandibular Abscess: This type of neck abscess forms under the tissues of the floor of the mouth. There is collection of pus under the tongue, which forces the tongue upwards and towards the back of the throat. This causes problems with breathing and swallowing. Ludwig's angina can commonly occur in young adults, particularly after a dental infection. It is, however, not common in young children.
  • Quinsy Abscess or Peritonsillar Abscess: This type of neck abscess forms beside the tonsils in the tissue walls, i.e. in the lymph glands present in the back of the throat. Young adults and adolescents are more susceptible to developing peritonsillar abscesses. Children rarely have them.

Causes of Neck Abscess

The common cause of a neck abscess is a bacterial or viral infection in the neck or head. The neck abscess can develop during or after infections, such as cold, sinus infection, tonsillitis or ear infection (otitis media). Worsening of the infection leads to its spreading down into the spaces of the deep tissue in the neck or posterior to the throat. There is collection of pus, which increases in these spaces resulting in formation of a mass. In some cases, a neck abscess can develop after an infection or inflammation of a congenital neck mass, such as thyroglossal duct cyst or a branchial cyst.

Signs & Symptoms of Neck Abscess

  • Fever.
  • Throat soreness with redness and swelling is one of the symptoms of neck abscess.
  • The tongue gets pushed upwards and backwards against the throat.
  • Yet another symptom of neck abscess is the presence of a bulge in the back of the throat.
  • Pain/stiffness in the neck.
  • Chills.
  • Ear ache.
  • Body pain.
  • Difficulty in talking, swallowing, or breathing.

Diagnosis of Neck Abscess

  • Physical examination along with a complete medical history is taken of the patient.
  • Throat culture is a procedure where a swab is taken from the back of the throat and is observed to determine the causative organism of the infection which is causing the neck abscess.
  • Blood tests are done to assess the body's response to infection.
  • X-ray is a diagnostic test, which produces images of bones, internal tissues and organs and helps in arriving at the diagnosis.
  • CT scan is an imaging test, which uses computer and x-rays to generate detailed horizontal or axial images of the body, including the organs, muscles, bones and fat. This test helps in differentiating an abscess from a cyst or a tumor.
  • Biopsy is a procedure where a sample of the tissue is taken with the help of a needle and sent to lab for testing to arrive at a diagnosis.

Treatment of Neck Abscess

Treatment of a neck abscess should not be delayed, as neck is a sensitive area and the abscess can compress the surrounding structures, such as the windpipe and cause many problems. Treatment of a neck abscess depends on:

  • The cause of the neck abscess.
  • Medical history, age and general health of the patient.
  • Severity of the neck abscess.
  • Patient's tolerance to certain medications, therapies or procedures.
  • Prognosis of the neck abscess.
  • Preference of the patient.

Treatment of Neck Abscess Comprises of:

Medications, such as antibiotics are given to treat the infection. In most of the cases, patient may need to be hospitalized and intravenous antibiotics are given. Pain killers are also prescribed to relieve pain from the abscess.

If the abscess does not get resolved with antibiotics, then drainage of the abscess needs to be done. This is accomplished with a needle and the patient may need to be hospitalized for this procedure. The pus sample collected from the drainage is sent to laboratory for culture and after the organism, which is causing the infection is determined, a specific antibiotic is prescribed accordingly.

Treatment of Neck Abscess by Drainage

Drainage of Superficial Neck Abscess

Draining of a superficial neck abscess is quite a simple procedure and is done under general anesthesia. A local anesthetic is also injected into the affected region. The lump, which is caused by the abscess, is then felt by the doctor to assess the areas, which has the most pus. The doctor then makes an incision in that region to drain the pus and a drain is then placed through the skin to prevent the pus from accumulating again. Culture of the pus done to determine the type of bacteria or organism which is causing the infection and according to the results of the culture, a specific antibiotic is prescribed to treat the infection.

Complications of Drainage of Superficial Neck Abscess

Complications of drainage of superficial neck abscess comprises of some bleeding. And also there are some abscesses, which have fistula in them (connected to skin) and should be drained and treated with special antibiotics on a long term basis.

Drainage of Deep Neck Abscess

Drainage of the deep neck abscesses can be done orally, i.e. through the mouth or transcervically, which is through the neck. Drainage through the oral route is done for abscesses formed in the peritonsillar space and in specific cases is done for abscesses formed in the retropharyngeal space. Other than these, all deep neck abscesses are commonly done through a surgical cut in the neck.

Complications of Drainage of Deep Neck Abscess

It is important to make sure that there is no obstruction in the airway when draining a deep neck abscess. For this reason, drainage of a deep neck abscess is always done in a hospital, so that emergency airway management is always available.

Home Remedies for Neck Abscess

  • Salt is very beneficial in treating an abscess naturally at home. Warm some salt in a pan till it is sufficiently hot, and then place the salt in a clean cloth and wrap around the abscess. The salt helps in absorbing the excessive pus and water and relieves the inflammation and the heat soothes the pain from abscess.
  • Pineapple is an effective home remedy for treating neck abscess. Eating pineapple on a daily basis helps in curing an abscess naturally at home. Pineapple contains
  • Bromelain, which helps in controlling inflammation and treating the abscess.
  • Raw onion is also an effective home remedy for treating neck abscesses. Onion contains anti-inflammatory properties. One simple method is placing a slice of raw onion on the abscess and covering it with a piece of clean cloth. Onion also helps in increasing the blood flow to the abscess thus helping the abscess to burst easily or make it ready for pricking and draining.
  • Echinacea contains antibacterial properties and can be an effective home remedy to get rid of abscess. Echinacea tea can be made by putting 5 teaspoons of the herb in boiling water and consuming it thrice a day.
  • Red clover has many medicinal properties and helps in treating abscesses. Dried flowers of red clover boiled in water can be consumed about couple of times a day for treating an abscess at home.
  • Application of a paste of turmeric powder and castor oil on the abscesses also help in curing the abscess.
  • Milk thistle is another flowering plant, which has many medicinal properties. Every part of milk thistle helps in relieving the abscess. The stem of milk thistle can be soaked in water and stewed and consumed. The root of milk thistle can also be eaten by roasting it in butter or boiling in water. The leaves of milk thistle can be eaten raw. Milk thistle capsules can also be taken for treating abscess.
  • Liberal application of aloe vera gel on the abscess is also very beneficial home remedy for treating abscesses.
  • Chamomile contains anti-inflammatory and antibacterial properties. Chamomile tea taken 3 to 4 times a day helps in treating a neck abscess naturally.
  • Every part of neem tree contains medicinal properties. A paste of neem leaves and water can be liberally applied on the abscess to relieve it.
  • Spirulina is rich in proteins, antioxidants and vitamin B. They can also be used in treating abscesses; however, its use in pregnancy and lactation should be avoided.
  • Placing a slice of raw potato over the abscess for about 20 minutes helps in drawing the toxins accumulated in the abscess and thus in relieving the abscess.
  • It is important to consume a healthy diet and drink lots of water to boost the treatment for abscess.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: May 4, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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