Deep neck space infection/supraglottis

Background: Deep neck space infections most commonly occur a complication of tonsillitis resulting in sepsis and often requires surgical intervention. They present similar to a quinsy with throat pain and trismus (reduced mouth opening). In addition, they often have pain / stiffness on moving their neck and they may be drooling due to the severity of the pain. They may have stridor. Oral examination may show tonsillitis. It can cause airway obstruction in severe cases or can result in sepsis. Complications include mediastinitis which carries a high mortality rate.

Supraglottitis is an acute onset infection of the throat that may present like tonsillitis but with normal oral examination. It causes narrowing of the airway just above the voicebox and can result in airway obstruction if untreated. There may be stridor.

Referral guidance:

Any patient with suspected deep neck space infection or supraglottitis should be referred to ENT as an emergency for immediate review