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Introduction. Cervical suppurations represent a demanding pathology chapter, constituting a major medical-surgical emergency, characterized by a particularly severe clinical picture that occurs especially in immunocompromised patients and associates multiple therapeutic difficulties, a poor prognosis and a high mortality rate. Diabetes mellitus is among the factors that confer a special severity to these cases; it induces a generalized metabolic dysfunction and deteriorated immunological status, such as the suppuration has a more severe evolution and a more rapid progression compared to non-diabetic patients. Materials and method. The authors present the case of a 62-year-old patient, with complicated insulin-necessitating diabetes mellitus and multiple cardiovascular comorbidities. He was admitted into our clinic for acute respiratory failure and locally extended cervical suppuration. Emergency tracheotomy and external cervical drainage were performed. Extention of the infectious process towards the mediastinum and the ensuing life-threatening complications thereafter were thus successfully prevented. Results. The patient undergoes periodic follow-up that includes clinical, biological and endoscopic evaluation, as well as effort tests. After three months, complete normal breathing was restored, rendering a normal aspect and function of the pharyngo-laryngeal region, and a permeable laryngo-tracheal axis. This allowed the tracheotomy closure. Conclusions. Neck suppurations of the diabetic patient constitute an important challenge for the ENT surgeon. They are major medical-surgical emergencies and raise diagnostic problems and necessitate complex staged therapy. Early diagnosis, prompt and adequate medical along with surgical treatment and dynamic follow-up are absolutely necessary for saving the patient’s life. [ABSTRACT FROM AUTHOR]

The authors present a deep neck space infection with particular evolution. Intraoperatory biopsy shows cellulitis of tuberculous origin. That is evidence for differential diagnosis difficulties related to cervical infections. It is mandatory that certain protocols should be respected with regard to deep neck infections, along with biological state evaluation for other conditions: immune deficiencies. [ABSTRACT FROM AUTHOR]