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Emergency Medicine4 papers

Splinter in neck with infection

Last edited: 4/15/2026

Overview

A splinter in the neck leading to infection can result in deep neck infections, often manifesting as abscesses, requiring prompt clinical evaluation and imaging.

Diagnosis

  • Clinical suspicion of infection should prompt imaging 1.
  • MRI is highly feasible and accurate for diagnosing neck infections, with a high positive predictive value for detecting infection (0.98) and abscesses (0.95) 1.
  • Radiological evidence of infection is observed in 95% of cases with MRI 1.
  • Abscess detection via MRI is reliable, identified in 72% of confirmed infections 1.
  • Management

  • Initial empirical antibiotic therapy should cover common pathogens (e.g., Streptococcus, Staphylococcus) pending culture results 1.
  • Surgical intervention may be necessary for abscess drainage in cases where medical management fails or abscesses are large 1.
  • Close monitoring for complications such as airway compromise is essential 1.
  • Special Populations

  • No specific data provided regarding pregnancy, pediatrics, elderly, or comorbidities in the given abstracts 1.
  • Key Recommendations

  • Utilize MRI as a first-line imaging modality for suspected deep neck infections due to its high diagnostic accuracy and feasibility 1 (Evidence: Strong).
  • Initiate empirical broad-spectrum antibiotics promptly upon clinical suspicion of infection 1 (Evidence: Moderate).
  • Consider surgical drainage for abscesses that do not respond to medical management or are large 1 (Evidence: Moderate).
  • References

    1 Nurminen J, Velhonoja J, Heikkinen J, Happonen T, Nyman M, Irjala H et al.. Emergency neck MRI: feasibility and diagnostic accuracy in cases of neck infection. Acta radiologica (Stockholm, Sweden : 1987) 2021. link

    Original source

    1. [1]
      Emergency neck MRI: feasibility and diagnostic accuracy in cases of neck infection.Nurminen J, Velhonoja J, Heikkinen J, Happonen T, Nyman M, Irjala H et al. Acta radiologica (Stockholm, Sweden : 1987) (2021)

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