Potential role of biofilms in deep cervical abscess

Objective: Neck abscesses are relatively common problems that are recalcitrant to antimicrobial therapy. The underlying pathogenesis of deep neck space abscess is poorly understood and drainage of these abscesses remains the cornerstone of treatment. Recently numerous infectious diseases have been linked to biofilm phenotypes. Study Design: Biofilms are unique lifestyle of microorganisms defined as an assemblage of microbial cells enclosed in an exopolysaccharide matrix and are recalcitrant to antimicrobial therapy. Biofilms due to their resistance to antimicrobial and host defenses are considered a model for chronic and recalcitrant infections. Recent work in other labs has demonstrated biofilm pods embedded intracellularly in adenoid specimens of patients with recurrent acute otitis media and chronic otitis media with effusion. This study sought to investigate the possible role of biofilms in deep neck space abscess. Setting: Academic practice Main outcome measures: Scanning electron microscopy was performed on biopsies taken from the abscess wall of deep cervical abscess at time of incision and drainage. Results:. 5 out of 7 samples showed evidence of biofilm formation on the abscess wall. Evidence of rods and cocci within the biofilm matrix were visualized on SEM. Conclusion: These findings suggest that biofilm phenotypes may play a role in the etiology of deep neck abscess. This may provide some explanation to the recalcitrant nature of deep neck abscess. It should be noted that this is the first identification of biofilm phenotypes in deep neck space abscess.