Raúl Romero-Cabello, Service of Infectology, Hospital General de México “Dr. Eduardo Liceaga”; Faculty of Medicine, Universidad Nacional Autónoma de México (UNAM); Instituto para el Desarrollo Integral de la Salud. Mexico City, Mexico
Mario A. Rodríguez-León, Instituto para el Desarrollo Integral de la Salud; Facultad de Estudios Superiores Zaragoza, UNAM. Mexico City, Mexico
Edgar Álvarez-Trejo, Instituto para el Desarrollo Integral de la Salud, Mexico City, Mexico

We present the case of deep abscesses in the posterior region of the neck in a 47-year-old man, decompensated diabetic, with a history of supracondylar amputation 3 years earlier, hypertensive and with proteinuria. The lesion consisted of an abscess that left two coalescing wounds in the fundus upon drainage: one 5 cm in diameter and 2 cm deep, the other 2.5 cm in diameter and 2 cm deep. The abscess was managed with mixed systemic antibiotic therapy (clindamycin plus clavulanic acid/amoxicillin orally and, drainage and debridement, as well as dressings with hydrogen peroxide and packaging with phenytoin suspension, non-adhesive hydro-foam with silver and a dressing with polyhexamethylene biguanide. 0.2%). The evolution was favourable with the control of the infection, granulation of the wound, adhesion of the skin to deep tissue and closure. In parallel, the metabolic and cardiovascular monitoring and control of the patient was carried out. The experience is shared for the handling of possible similar cases.

Keywords: Deep neck abscesses. Diabetic chronic complications. Local phenytoin adjuvant. Cutaneous abscess in diabetes.