Salmonella Neck Abscess as an Opportunistic Infection in Diabetes Mellitus

Salmonella neck infections represent an uncommon cause of focal salmonellosis. While the incidence of nontyphoid salmonellosis is estimated at over 2 million cases annually, extraintestinal manifestations account for less than 1% of cases. This paper describes two patients with Salmonella neck abscesses as the initial presentation of diabetes mellitus. The first patient was diagnosed as having Salmonella enterica serotype Enteritidis sternocleidomastoid pyomyositis and the second patient Salmonella enterica serotype Typhimurium parapharyngeal abscess. Both patients had elevated hemoglobin A1c levels and had not been previously diagnosed with diabetes mellitus. Salmonella spp. should be on the differential as a causative pathogen in patients presenting with neck abscesses and poorly controlled glucose levels. Diabetes may be a risk factor for salmonellosis due to decreased gastric acidity and prolonged gastric transit time. Prompt incision and drainage accompanied by antibiotics remains the treatment of choice for infected neck abscesses.