An unusual neck abscess by Salmonella in an immunocompromised host

Abstract:

Neck abscesses are commonly caused by Staphylococcus aureus and Streptococcus species, while Salmonella is a rare pathogen in such infections. Extraintestinal manifestations of Salmonella are uncommon and usually occur in immunocompromised hosts. We report a 43-year old female with uncontrolled type 2 diabetes mellitus who presented with a painful swelling on the right side of the neck, associated with fever and dysphagia. Clinical examination and imaging confirmed a deep cervical abscess. Incision and drainage performed, yielding hemo-purulent material. Culture revealed Salmonella enterica serovar Typhimurium, resistant to ampicillin but sensitive to ceftriaxone, ciprofloxacin, and azithromycin. Blood cultures were sterile. The patient received intravenous ciprofloxacin for 7 days followed by oral ciprofloxacin for another 7 days, along with strict glycemic control. She showed marked improvement with complete recovery on follow-up. This case highlights Salmonella as an unusual but important cause of deep neck abscess in immunocompromised individuals. Early microbiological diagnosis and targeted therapy are essential for favorable outcomes. Clinicians should consider atypical organisms in patients with diabetes or other immunosuppressive conditions presenting with deep neck infections.