From the Guidelines
Phlegmon in the throat is a severe inflammatory condition characterized by the spread of infection through soft tissues without forming a distinct abscess. It typically develops as a complication of bacterial throat infections, particularly streptococcal or staphylococcal infections. Treatment requires prompt medical attention and usually involves a combination of broad-spectrum antibiotics such as amoxicillin-clavulanate (875/125 mg twice daily), clindamycin (300-450 mg four times daily), or a combination of a third-generation cephalosporin with metronidazole for 10-14 days, as recommended by the Infectious Diseases Society of America 1. Severe cases may require hospitalization for intravenous antibiotics, possible surgical drainage, and airway management. Symptoms include severe throat pain, difficulty swallowing, fever, neck swelling, and voice changes. The condition is dangerous because the infection can spread to adjacent structures, potentially causing airway obstruction, mediastinitis, or sepsis. Unlike a discrete abscess, phlegmon represents diffuse inflammation and infection spreading through tissue planes, making it particularly concerning and requiring aggressive treatment to prevent serious complications. Key points to consider in management include:
- Prompt diagnosis and treatment to prevent complications
- Use of broad-spectrum antibiotics as first-line treatment
- Consideration of hospitalization for severe cases or those with significant comorbidities
- Monitoring for signs of complications such as airway obstruction or sepsis. Given the potential severity of phlegmon, aggressive treatment with broad-spectrum antibiotics is recommended to prevent serious complications and improve outcomes, as supported by guidelines from the Infectious Diseases Society of America 1.
From the Research
Definition of Phlegmon in the Throat
Phlegmon in the throat refers to a rare and serious condition characterized by a diffuse inflammatory process that can affect various structures in the head and neck region, including the throat. This condition is often associated with high mortality and requires prompt medical attention 2, 3.
Causes and Risk Factors
The causes of phlegmon in the throat can vary, but it is often related to infections such as acute pharyngitis, tonsillitis, or odontogenic infections 4, 3. Other risk factors include uncontrolled diabetes mellitus, immunocompromised states, and previous history of respiratory infections 5, 6.
Clinical Presentation
The clinical presentation of phlegmon in the throat can include symptoms such as:
- Severe throat pain
- Difficulty swallowing
- Fever
- General weakness
- Chest pain
- Odynophagia (painful swallowing) 5, 6
Diagnosis and Treatment
Diagnosis of phlegmon in the throat is often based on clinical presentation, laboratory results, and imaging studies such as computed tomography (CT) scans 2, 3. Treatment typically involves surgical incision and drainage, antibiotics, and analgesia 2, 3. The choice of antibiotic therapy depends on the underlying causative agent and may include broad-spectrum antibiotics such as penicillin, metronidazole, or clindamycin 6, 2.
Complications and Prognosis
If left untreated, phlegmon in the throat can lead to serious complications such as: